Market Development Advisor, Medicaid
Become a part of our caring community and help us put health firstHumana Healthy Horizons is seeking a Market Development Advisor who will provide support to Humana’s Medicaid Plan. The Market Development Advisor works on problems of diverse scope and complexity ranging from moderate to substantial. The Market Development Advisor is the primary point of contact for the overall provider network development and indirectly leads a cross-functional team of contractors and report progress to leadership. This role is key to Humana’s Medicaid growth strategy.
The Market Development Advisor serves as the primary resource for state contractual commitments and requirements for provider networks. They will focus on methods to measure network accessibility and availability, supporting complex negotiations and the healthcare services render by provider types. Advises executives to develop functional strategies 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.
Leads network governance meetings to proactively identify network issues and solutions, and report progress to senior leadership.
Leads the medical / physical health, behavioral health, national ancillary, long term services and support, pharmacy and other contracting teams to track network development milestones.
Owns the network adequacy evaluation process and decides on approaches to closing network gaps.
Identifies, selects and prioritizes contracting targets to close network gaps.
Understands the complex contractual requirements and proposal commitments and independently leads cross-functional teams across multiple areas to fulfill those requirements and commitments.
Use your skills to make an impact
5+ years’ experience with Medicaid/Medicare/Employer Group operations and/or managing large scale projects and cross functional teams.
2 or more years of project management experience and/or provider contracting/network management experience.
Intermediate to advance skills in MS Office products specifically PowerPoint & Excel.
Success in developing working relationships within a highly matrixed business environment.
Ability to analyze data and make informed recommendations.
Intermediate experience using Excel (import data, pivot tables, formulas)
Experience responding to state and/or federal government solicitations.
Experience developing relationships with key stakeholders to understand and improve the market.
Workstyle: Remote work at home
Schedule: Monday through Friday 8-5 Eastern time and able to accommodate schedules and meetings in both Central and Eastern time zones.
Travel: Less than 10% travel. Travel maybe required outside the state residence.
As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
Social Security Alert Statement
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.
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.
Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:
- Health benefits effective day 1
- Paid time off, holidays, volunteer time and jury duty pay
- Recognition pay
- 401(k) retirement savings plan with employer match
- Tuition assistance
- Scholarships for eligible dependents
- Parental and caregiver leave
- Employee charity matching program
- Network Resource Groups (NRGs)
- Career development opportunities
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.
$93,000 - $128,000 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.