Become a part of our caring community and help us put health firstThe Associate VP, Clinical Program Strategy will be responsible for managing the portfolio of clinical programs to improve medical trend utilization with a focus on programs that impact acute and post-acute care. The Associate VP, Care Management requires an in-depth understanding of how organization capabilities interrelate across segments and/or enterprise-wide.The Associate VP, Clinical Program Strategy will be responsible for managing the portfolio of clinical programs to improve medical trend utilization with a focus on programs that impact acute and post-acute care. Decisions are typically related to intradepartmental coordination, development, and implementation of strategic plans, with business case that clearly outline value creation, and pursuit of an evaluation plan in partnership with Humana's trend bending research evaluation team.Required Qualifications
Bachelor's degree in business or health Administration.
10 or more years of technical experience
8 or more years of population health experience
Prior work experience in the health solutions industry with demonstrated success directing and leading teams.
Proficiency in analyzing and interpreting utilization data and how it correlates with financial trends.
Excellence in program management skills, including executive milestone development, reporting, and creation of mitigation plans.
Comprehensive knowledge of all Microsoft Office applications, including Word, power BI, Excel, project plan software, and Access.
Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
Preferred Qualifications
Clinical degree
Extensive experience in finance, cost of care programs, trend bending programs.
Major Duties and Responsibilities
Manage a comprehensive clinical portfolio related to acute and post-acute care utilization to improve trend with active cross collaboration with the clinical effectiveness and the Care Integration Team.
Develop and present formal business cases and ROI analysis to support acute and post-acute care trend bending clinical programs - including new ways of thinking, working and execution.
Proactively identify additional opportunities for automation, innovation, productivity, and efficiency initiatives for clinical programs, both delegated and non-delegated services.
Acts as a liaison and coordinates executive presentations with the TMO and Associate VP of Operations, Associate VP of Data Science, and Associate VP of Vendor management.
In partnership with the clinical effectiveness team and data science team identify key trends and opportunities that will inform innovative clinical programs to impact acute and post-acute care trends.
Support the development and execution of clinical program strategy for acute and post-acute care and roadmap that supports business goals and objectives.
As new opportunities are identified lead productivity, continuous improvement, configuration, user adoption, and efficiency initiatives for the care integration team.
Develop, track, and report key performance indicators (KPI) that drive business decisions for clinical programs, including care integration team and vendor services.
Manage, prioritize, and/or escalate technical support and clinical program training processes.
Identify, prioritize, and implement process improvement solutions to meet SLAs, create triggers to initiate collection of action plans by Division Directors, and summarize action plan findings.
Develop the evaluation plans and evaluation results in partnership with data science team, Humana's HRR and/or Behavioral Economics team, and Finance; establish sound clinical leading indicators and appropriate study designs for new programs.
Partner with HUM and CW clinical programs leaders to leverage cross-asset best practices, align patient-facing experience, and design.
Oversee program co-development with external vendors; lead trend bending vendor conversations and provide oversight vendor outcomes management for Care Model and Innovation.
Create analytics plans that identify opportunities by cost and quality metrics.
Represent PCO across the enterprise to ensure that our efforts are broadly recognized.
Use your skills to make an impactReporting Structure:The AVP will report to the VP Clinical Innovations and will have up to 6-8 direct reports, including 2-3 dotted line reports directly managed in other areas of the organization.Working Conditions:RemoteScheduled Weekly Hours40Pay RangeThe compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$181,200 - $249,300 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of BenefitsHumana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About usAbout CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient's well-being.About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation's largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first - for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.Equal Opportunity EmployerIt is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options https://www.partnersinprimarycare.com/accessibility-resources