Become a part of our caring community and help us put health first
 

The Clinical Strategy Team is a multi-disciplinary team focused on using data analysis and clinical acumen to build strategies that improve experiences for our members and providers, drive positive health outcomes, and reduce total cost of care. We are seeking a Clinical Strategy Lead to build-out our strategy and approach to ensure our members get the highest quality care, which may include supporting our members going to the highest quality providers, while also understanding root causes of high and low quality care and building strategies to improve quality of care offered. This will involve close partnership with analytical and clinical SMEs to identify opportunity areas, and operational business partners to bring strategies to life. Purpose is to help our members achieve optimal health outcomes and cost-effective care.

Location: remote

The Clinical Strategy Lead will lead high-value, strategic initiatives that directly impact health outcomes and total cost of care of Humana’s 5M+ membership. The Clinical Strategy Lead will partner with analytics and clinical SMEs to improve our understanding of provider quality and performance, and then figure out how we support our members getting the highest quality care. This may include identifying new approaches to influence members going to the highest quality providers, as well as understanding root causes of high and low quality care and building strategies to improve quality of care offered. In this Lead role, you’ll have the opportunity to analyze complex business and clinical issues leveraging healthcare and operational data, while working collaboratively with clinicians, data scientists, actuaries, subject matter experts, and business owners across Humana to drive solutions forward. In this role you will lead quantitative and qualitative analysis to identify actionable insights and bring the insights to action through cross-organizational collaboration.

Responsibilities include:

• Identify ways to use Humana capabilities to improve members getting best quality care, which may include ways to influence members choosing or getting referred to the highest quality providers, as well as ways to influence providers to improve quality of care offered.

• Develop a strategy and recommendations based on opportunity areas identified in partnership with analytics, clinical SMEs and operational partners, get buy-in from leadership and business partners, and help guide implementation.

• Partner closely with data scientists, actuaries, and clinical associates to frame-up an analytics question, guide analysis, and draw actionable insights to inform strategy.

• Synthesize evidence from clinical literature and guidelines, as well as conduct more broad external research (e.g. competitive intelligence), to come up with ideas on approach.

• Develop a learning agenda and test plans to ensure we get the learnings from new initiatives to understand their impact and inform future direction.

• Utilize strong interpersonal skills, presentation skills, and storytelling skills to get alignment on initiatives among senior leaders, business partners and other stakeholders.

• Produce high quality presentations and reports, to be shared with senior leaders, business partners, and other stakeholders.

• Work cross-functionally with key partners to drive results.

• Identify important clinical and experience problems and build the business case to solve them through application of clinical, analytical, and business expertise.

This role will be a great fit if:

• You are passionate improving health outcomes of seniors and ensuring they get the high quality care.

• You are driven – you’re eager to use your strong strategic and analytical acumen to drive impact and create significant measurable value.

• You are collaborative – you like partnering with diverse teams across the enterprise to develop strategies and solutions that will work.

• You are curious – you enjoy learnings new things, welcome diverse perspectives, and thrive figuring out new paths forward.

Use your skills to make an impact
 

Role Essentials

• Bachelors degree

• 7 years or more of healthcare experience (payor, provider, consulting or otherwise)

• Some provider experience, which could include working within a provider organization, working for provider clients/ customers, or related provider experience

• Strategy experience; experience using quantitative and qualitative data to build strategic recommendations and presenting to senior leaders

• Self-starter; ability to proactively anticipate needs, create a plan, and problem solve

• Experience in guiding analytics/studies and analyzing data to generate insights

• Experience synthesizing evidence from peer-reviewed literature

• Demonstrated ability to work cross-functionally across multiple teams to drive results

• Excellent interpersonal, negotiation and communication skills

• Comfortable building presentations and communicating to senior level leadership

• Proficient in Excel

Role Desirables

• Advanced degree (Masters or Doctorate) in business (MBA), Public Health, Epidemiology, healthcare, Clinical Informatics or related field

• Clinical license (e.g. MD, DO, PharmD, APRN, PA, NP, BSN, RN)

• Highly creative and able to think “outside the box

Additional Information

As 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.

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 Hours

40

Pay Range

The 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.

 

$115,200 - $158,400 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, 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.

Application Deadline: 01-29-2025

About us
 

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 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.