Become a part of our caring community and help us put health firstWe are seeking an accomplished healthcare leader for the newly created role of Associate Vice President (AVP), Clinical Strategy. In this role, you will be a key enterprise leader responsible for evolving Humana's clinical strategy, with a focus on our 5+ million Medicare members. You will facilitate the delivery of high quality, appropriate, and cost-effective care for Humana's members. Specifically, you will: (1) identify areas where our members are failing to receive appropriate, or receiving inappropriate, health care services that have adverse impacts on their health outcomes, and (2) partner across the enterprise to leverage Humana's industry leading plan operations and programs to ensure that our members receive high-value and appropriate care. The Associate Vice President, Clinical Strategy will lead a multi-disciplinary team and will report directly to our Vice President, Clinical Strategy. This position can be located anywhere within the lower 48 states.Associate Vice President, Clinical StrategyHumana is a $100 billion (Fortune 50) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we serve, Humana is committed to advancing the employment experience and vitality of the associate community. Through offerings anchored in a whole-person view of human well-being, Humana embraces a focus on stimulating positive individual and population changes while nurturing a sense of security, enabling people to live life fully and be their most productive.Against that backdrop, we are seeking an accomplished healthcare leader for the newly created role of Associate Vice President (AVP), Clinical Strategy. In this role, you will be a key enterprise leader responsible for evolving Humana's clinical strategy, with a focus on our 5+ million Medicare members. You will facilitate the delivery of high quality, appropriate, and cost-effective care for Humana's members. Specifically, you will: (1) identify areas where our members are failing to receive appropriate, or receiving inappropriate, health care services that have adverse impacts on their health outcomes, and (2) partner across the enterprise to leverage Humana's industry leading plan operations and programs to ensure that our members receive high-value and appropriate care.To succeed in this position, you must appreciate the needs of our Medicare members, the gaps in care that lead to poor outcomes and avoidable spending, the challenges of closing these gaps within the current system, and the highest yield opportunities for improvement. You must also be passionate about collaborating and partnering across the enterprise (e.g., with Network, Markets, Clinical Operations, Analytics, etc.) to develop discrete strategies and to ensure execution of those strategies. And finally, you must be driven by sustainably improving health outcomes for our members. Success will be measured by the development and implementation of programs that have clear and measurable impacts on health outcomes and medical cost savings.The Associate Vice President, Clinical Strategy will lead a multi-disciplinary team and will report directly to our Vice President, Clinical Strategy. This position can be located anywhere within the lower 48 states.Key Responsibilities :
The AVP, Clinical Strategy will refine, expand, and advance Humana's efforts to improve outcomes and drive reductions in total cost of care. This will entail leading two distinct but closely related bodies of work- Opportunity Identification and Solution Development
The AVP, Clinical Strategy will lead opportunity identification for clinical quality improvement and clinically oriented medical cost management activities within the Medicare line of business. This will entail working across analytic and finance teams, clinicians, and other experts to 1) identify instances where Humana members are failing to receive timely, appropriate, cost-effective care and 2) quickly size the impact of these gaps in care on health outcomes and excess medical spending. Often, these opportunities will be identified through clinical practice guidelines, clinical literature, member and provider feedback, and industry intelligence. It is also expected that opportunities will be identified by more real-time monitoring and analyses of emerging trends in health care utilization among Humana members.
Once opportunities have been identified, the AVP, Clinical Strategy will collaborate with partners across the enterprise to develop, implement, evaluate, and optimize a portfolio of solutions that improve health outcomes and reduce medical costs. The AVP, Clinical Strategy will have principal accountability for solutions that leverage Humana's leading plan operations and capabilities in Network Design (e.g. provider performance management, network optimization, incentives, contracting) and Clinical Operations (e.g. coverage policies, enforcement, claims payment). It is expected that opportunities identified will also be impactable with other levers or capabilities (e.g. benefit design, vended solutions, clinical programs) and in these instances, the AVP, Clinical Strategy and their team will collaborate with other leaders in the Clinical Strategy organization for design and execution.
Over time, the AVP, Clinical Strategy will be accountable for a multi-year pipeline and portfolio of initiatives that have clear and measurable impacts on health outcomes and medical cost savings.
This role will lead a multidisciplinary team of 10-15 associates, with potential for growth over time
Use your skills to make an impactKey Candidate Qualifications :Required Qualifications
Significant (typically 10+ years) of healthcare industry or related experience leading the development and implementation of complex strategic, clinical, and/or operational initiatives
Experience leading cross-functional teams to execute on complex projects within a matrixed organization. Ability to lead a diverse group of people toward a common vision with proven results related to motivation, engagement, and goal attainment
Highly collaborative mindset and excellent relationship-building skills, including the ability to engage many diverse stakeholders and SMEs and win their co-ownership in the outcome, particularly in scenarios that require 'tough conversations'
Experience and demonstrated skill as an effective people leader
Strong analytic acumen: ability to leverage data to drive decision making and improve outcomes
Proven organization, planning, and prioritization skills to collaborate with multiple internal stakeholders concurrently and to manage the complexity of competing priorities
Understanding of health plan operations and clinical and business analytics
Excellent, executive-level verbal and written communication skills
Preferred Qualifications:
PhD, MBA, MPH or other advanced degree in relevant field
Experience leading analytic teams, or collaborating closely with analytics teams
Clinical training and/or experience evaluating clinical literature, quality measures, and clinical practice guidelines
Scheduled 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 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 usHumana Inc. (NYSE: HUM) is committed to putting health first - for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.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.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 https://www.humana.com/legal/accessibility-resources?source=HumanaWebsite.