Humana

About Humana

 

Job Category:

Enterprise Development - Strategy

Country:

United States

Postal Code:

40201

Approximate Salary:

Not Specified

Position Type:

Full Time

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Medicaid/Duals Strategy Advancement Advisor

Humana - Louisville, Kentucky

Posted: 08/24/2018

Description

The Medicaid/Duals Strategy Advancement Advisor provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for business segments or the company at large. The Strategy Advancement Advisor works on problems of diverse scope and complexity ranging from moderate to substantial.

Responsibilities

The Strategy Advancement Advisor leads initiatives to analyze complex business problems and issues using data from internal and external sources. Brings expertise or identifies subject matter experts in support of multi-functional efforts to identify, interpret, and produce recommendations and plans based on company and external data analysis. Ensures that policies and procedures align with corporate vision. Selects, develops, and evaluates personnel ensuring efficient operation of the function. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.

The Strategy Advancement Advisor is responsible for the following:

• Oversee and manage the development of RFP narrative responses for Provider Network build assigned questions
• Develop and support strategies and innovative approaches to evolving Medicaid/LTSS/Duals provider marketplace
• Engage in stakeholder and association level relationship development meetings in current and prospective new markets
• Coordinate and collaborate with Medicaid leadership, business partners, and market leadership on network build and adequacy reporting progress
• Partner closely with National and Market Contracting teams to anticipate level of effort, develop project plan and roadmap to success for network build and provider management
• Understand network build requirements and analyze network adequacy in order to help secure strong competitive networks in anticipation/response to RFPs
• Define the scope of network builds project and coordinate activities to achieve business objectives within a pre-determined timeframe
• Interpret state requirements for RFP network file submissions
• Plan, analyze, anticipate and mitigate constraints, risks, and issues; and adjust existing systems, processes, and capabilities to achieve results

               

Required Qualifications

  • Typically requires a Bachelor's degree and 8+ years of technical experience, or equivalent and 2+ years of project leadership experience
  • 5+ years of Medicaid experience
  • 5+ years of network development experience
  • At least one year of experience in the health insurance industry
  • Experience working with MS Office Suite, specifically Word and Excel
  • Ability to collaborate effectively with personnel at all levels, from administrative support to subject matter experts to leadership
  • Strong leadership, organizational planning, prioritization, and time management skills; the ability to multitask and work against strict deadlines
  • Flexibility in the face of rapidly changing circumstances (i.e. – occasional nights and weekends)
  • Strong reading comprehension and writing skills
  • Strong project management skills with high personal accountability
  • Must be organized and able to work with accuracy and efficiency on multiple projects with multiple teams simultaneously
  • Experience in a deadline-driven environment with high attention to detail and compliance
  • Must be detail-oriented, self-motivated, and possess a quality customer service attitude
  • Desire to join a high-functioning, collaborative, and supportive team culture

Preferred Qualifications

  • MBA
  • PMP
  • Medicaid and Duals network development experience
  • 1 – 3 years’ experience in Medicare/Medicaid Strategy or Business Development
  • 1 – 3 years’ experience supporting Dual-Eligible Special Needs Plans (D-SNP)

Scheduled Weekly Hours

40

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