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Advisor, Medicaid Provider & Network Strategy

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Humana

1mo ago

  • Job
    Full-time
    Senior (5-8 years)
  • Dallas

AI generated summary

  • You must have expertise in Medicaid, strong analytical skills, experience in network strategy, and effective communication abilities to engage with providers and stakeholders.
  • You will develop and implement strategies for Medicaid provider networks, analyze data to optimize performance, and collaborate with teams to ensure effective provider engagement and support.

Requirements

  • Required Qualifications
  • Bachelor's degree
  • 5+ years of experience in network development, contracting, and/or network management or provider relations experience
  • 2+ years of project leadership experience
  • 2+ years of Medicaid experience/Managed Care
  • Preferred Qualifications
  • Master’s degree in business administration, healthcare administration, public administration, public health, or public policy.

Responsibilities

  • Oversees the creation of a playbook that drives Humana’s provider & network market entry strategy decisions.
  • Works cross functionally to seek consult and provide advisement on a proposed network build approach and timeline based on analysis of internal and external source data and managed care program requirements.
  • Drives market competitor analysis and the evaluation existing managed care requirements to assess gaps in Humana’s pre-rfp & market entry provider & network strategy.
  • Leads network workstream meetings, including content creation from the market development kick-off through the initiation of the network build.
  • Presents to Medicaid senior leadership regular progress updates on Provider & Network Strategy in assigned markets.
  • Develops provider & network strategies based on insights from the playbook in assigned Medicaid pipeline markets to support RFP responses and market entry.
  • Serves as the market subject matter expert to assist business development in developing provider & network request for proposal (RFP) responses.

FAQs

What is the primary responsibility of the Advisor, Medicaid Provider & Network Strategy at Humana?

The primary responsibility of the Advisor is to lead the development of Humana Healthy Horizon’s provider and network market entry strategy for its Medicaid growth markets, ensuring the creation of robust, adequate, and accessible networks through data-driven research and strategic advisement.

What qualifications are required for the Advisor position?

Candidates must have a Bachelor's degree, at least 5 years of experience in network development, contracting, or provider relations, along with 2 years of project leadership and Medicaid/Managed Care experience.

Are there any preferred qualifications for this role?

Yes, a Master’s degree in business administration, healthcare administration, public administration, public health, or public policy is preferred for this role.

Is travel required for this position?

Yes, up to 10% travel is expected for the Advisor role.

What type of skills are important for this position?

Important skills include strong project management, the ability to analyze qualitative and quantitative data, excellent interpersonal and communication skills, and proven experience in writing and delivering presentations to management and internal business partners.

What type of team dynamics can be expected in this role?

The Advisor will work cross-functionally, collaborating with various teams to provide strategic advisement and recommendations concerning network build approaches and timelines based on internal and external data.

How will performance be evaluated in this position?

Performance will be evaluated based on the ability to develop effective provider and network strategies that support RFP responses and market entry while successfully managing projects and presenting updates to senior leadership.

What compensation range is offered for this position?

The compensation range is between $112,400 and $154,900 per year, with eligibility for a bonus incentive plan based on individual and company performance.

Does Humana offer benefits for this position?

Yes, Humana offers competitive benefits including medical, dental, and vision coverage, a 401(k) retirement savings plan, paid time off, short-term and long-term disability, life insurance, and other wellness opportunities.

How is the hiring process structured for this position?

The hiring process includes the use of an interviewing technology called HireVue, which allows candidates to connect and share their skills and experience at their convenience.

What is the stance of Humana regarding equal employment opportunities?

Humana has a policy of not discriminating against any employee or applicant based on various factors such as race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status, and takes affirmative action to promote diversity in employment.

Humana

Science & Healthcare
Industry
1001-5000
Employees
1961
Founded Year

Mission & Purpose

At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.