Program Delivery Lead
Become a part of our caring community and help us put health firstHQRI is an organization that is responsible for improving health outcomes and advancing the care experience of our members and provider partners through integrated risk adjustment (RA) and quality (Stars) solutions that leverage data and technology to empower members, providers, and Humana. Health Quality and Stars (HQS) is committed to caring for our customers and delivering high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS).
The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures covering preventive care screenings, health condition management, health outcomes, patient experience, and plan operations. Humana has led national competitors for the past five years in the percentage of members in plans rated 4 star or higher, which is a testament to the caring, curious, and committed nature of this highly talented team.
Stars Innovation is seeking a Program Delivery Lead to drive the program management of initiatives that help maintain Humana’s industry leading Stars results. This leader will influence partners throughout the company to co- develop shared objectives, creating alignment on strategic direction and prioritization of focus areas in effort to drive the advancement of opportunities for Stars measure improvement. This individual has an in-depth understanding of how Enterprise functions interrelate and can collaborate effectively with partners.
The Program Delivery Lead will:
- Be accountable for strategy and program management of initiatives for complex measures focused on Care Coordination to drive overall Stars performance
- Collaborate with internal partners to identify, develop, and deliver solutions to overcome barriers to measure success
- Proactively engage stakeholders to anticipate headwinds and implement solutions to prevent negative impacts to performance
- Oversee complete lifecycle of initiatives (idea through implementation); Utilize outcomes to inform continuous improvement and strategic recommendations
- Provide insights and identify new opportunities for improvement through data analysis of variable factors and determine course of action
- Create collaborative working relationships with teams within and outside of Stars
- Support education of Stars measures to other enterprise partners
- Analyze and understand other enterprise processes and capabilities to determine impact to Stars
- Act as an advocate for Stars across the enterprise
- Understanding of or experience with clinical settings to advance provider first strategies, influence member interventions, and identify new opportunities to impact
- Demonstrate ability to influence multiple stakeholders at all organizational levels
Use your skills to make an impact
- Bachelor's degree
- A minimum of 3 years product or program ownership experience
- Proven skills in analyzing data trends and identifying performance improvement opportunities
- Excellent communication skills, both oral and written
- Strong attention to detail and focus on customer and associate experience
- Effective facilitator -- direct collaborative efforts amongst business, analytics, and technology partners
- Master's Degree in Business Administration or a related field
- Clinical background
- Prior Medicare/Medicaid experience, knowledge of Stars and CMS quality measures
- PMP certification a plus
- Six Sigma Certification also a plus
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
As part of our hiring process for this opportunity, we will be using an interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire 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.
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 [email protected] with instructions on how to add the information into your official application on Humana’s secure website.
Scheduled Weekly Hours40
Pay 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.
$112,400 - $154,900 per year
This 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.
Humana 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 Employer
It 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.