Become a part of our caring community and help us put health firstThe Strategy Advancement Advisor plays a crucial leadership role that provides data-driven strategic guidance to deliver a consistent and best-in-class Clinical function. The Strategy Advancement Advisor also enhances operational stability and effectiveness for market-based processes that support authorization business levers. This role calls for a dynamic leader capable of tackling various business challenges, building relationships in a highly collaborative environment, influencing through communication, and leveraging data to advise senior and executive leaders.This role requires strong leadership, analytical skills, and the ability to collaborate effectively with various stakeholders to drive strategic advancements in the Clinical - Utilization Management operating model. The Advisor must exercise independent judgment and decision-making on complex issues regarding roles/responsibilities, KPIs, staffing levels, and other related tasks while working under minimal supervision.ResponsibilitiesManage the operating model elements of the Clinical - Utilization Management (UM) domain
Serve as the primary point of contact (POC) to discuss, troubleshoot, or develop new capabilities or responsibilities over time to align with evolving business priorities, processes, and provider landscape
Continuously optimize the existing operating model by leveraging performance and productivity data and front-line associate feedback
Optimize the operating model by identifying and scaling best practices while eliminating unnecessary requirements or processes
Manage test and learn (T&L) programming that serves to pilot deviations to the standard operating model with an ultimate goal of scaling those initiatives that increase performance and/or efficiency. Management of the T&L program includes:
Facilitating ideation sessions
Managing approvals and ROI analysis
Driving decisions to scale successful ideas/pilots, and
Supporting change management to successfully integrate/scale successful ideas/pilots
Maintain the staffing model and roles/responsibilities
Own the development, maintenance, enhancement, and continuous improvement of the UM staffing model
Lead operating model design, including defining role responsibilities for Clinical associates
Serve as the primary point of contact for discussions, troubleshooting, and development of new responsibilities to align with shifting business priorities
Develop, maintain, and monitor KPIs
Work with enterprise partners to define business and operational performance KPIs/metrics aligned with clinical strategic outcomes
Collaborate with enterprise partners to develop KPIs and activities to measure operating model performance, adherence, and productivity
Partner with owners of enterprise dashboards and reports to monitor performance and measure adherence to KPIs
Develop executive reports that communicate the UM operating model productivity and effectiveness
Leadership of Special Project Teams
Lead and manage 15 special project teams focused on various productivity initiatives.
Ensure each team has clear objectives, milestones, and deliverables.
Provide strategic direction, guidance, and support to project teams.
Foster a collaborative and high-performance team culture.
Project Management and Execution
Monitor and evaluate the progress of special project teams, ensuring timely and successful completion of projects.
Identify and mitigate risks associated with project implementation.
Ensure efficient resource allocation and utilization across projects.
Utilize project management tools and methodologies to track progress and outcomes.
Use your skills to make an impactRequired Qualifications
3+ years of leadership skills and proven ability to lead through influence
3+ years of technical experience with expertise in data analytics and reporting
Effective communicator with the ability to appropriately guide senior leadership
Ability to use data to validate performance and provide leadership insights
Ability to build consensus and alignment with programs
Preferred Qualifications
Bachelor's degree highly preferred
Additional InformationAs part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.WAH / Internet Guidance:To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
SSN Alert: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website.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.$112,400 - $154,900 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 veteran status. 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.
