Director, Enterprise Activation Provider...

The Director, Provider Performance Strategy is responsible for leading Enterprise Activation’s provider performance infrastructure, including provider strategy, provider programs, reporting and dashboard capabilities, connectivity initiatives, data quality, and performance governance. This leader develops and optimizes the programs, insights, and roadmap that support providers, markets, and enterprise partners in improving Medicare Stars performance and health outcomes.

The role serves as the enterprise owner for provider-facing capabilities-including reporting, performance frameworks, provider optimization programs, and works closely cross functional partners to ensure enterprise strategies are effectively deployed and utilized.

Primary Enterprise Stars Focus:

Provider Performance Strategy and Optimization

Provider Programs, Incentives and Reporting

Data Quality & Performance Integrity

Reporting Governance & Prioritization

Performance Infrastructure & Analytic Frameworks

The Director, Enterprise Activation: Provider Performance Strategy serves as the enterprise Stars leader responsible for Stars Market/provider performance strategy, provider-focused Stars optimization programs, provider reporting data connectivity, performance governance, and effectiveness to drive Stars performance.

This leader develops and advances the provider Stars performance systems, reporting, and programs that enable providers to improve quality performance, enhance member outcomes, and drive Medicare Stars results. The role partners closely with enterprise teams including Markets, Provider Enablement, Clinical, Digital, Analytics, Operations, IT, and external provider organizations to ensure enterprise provider strategies are aligned, scalable, and outcome-focused., 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 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 you.

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.

Work at Home Requirements: 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 required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana’s offices for training or meetings may be required.

Scheduled Weekly Hours

40

• Bachelor’s degree

• 8+ years of progressively responsible leadership experience in Medicare Advantage, provider performance, quality improvement, population health, healthcare analytics, provider engagement, or 5 years of experience at a top tier consulting firm

• 3+ years working experience in Medicare Advantage Stars, HEDIS, quality measurement, and provider performance improvement.

• Experience developing provider reporting, performance management, or provider engagement and experience strategies.

• Demonstrated experience analyzing provider quality and performance data across Medicare Advantage, Stars, HEDIS, value-based care, or related healthcare programs

• Experience leading enterprise-wide initiatives across multiple business functions.

• Strong strategic planning, business analysis, and program management skills.

• Experience managing complex stakeholder relationships across business and clinical organizations.

Role Desirables

• Experience supporting provider groups and value-based care arrangements

• Experience with healthcare interoperability, APIs, FHIR, HL7, and healthcare data exchange models.

• Black belt, Six Sigma, SQL/Python Coding

Additional Information

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

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.

$150,000 - $206,300 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Stars Provider Performance Business Systems Strategy

• Lead the Stars strategy, governance, and optimization of enterprise provider reporting, dashboards, provider facing quality improvement programming and performance management.

Stars Provider Programs** **Performance Optimization

• Lead governance, performance management, and optimization of provider-focused Stars programs and provider-facing engagement and quality improvement solutions.

Stars Provider Ecosystem Strategy & Activation

• Develop enterprise-wide Stars provider engagement, segmentation, activation, and optimization strategies that align reporting, incentives, programs, Markets and Provider organizations to improve quality performance, remove adoption barriers, and drive coordinated execution., About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.