You will possess Medicaid managed care business development and operations expertise and have experience in designing solutions for key Medicaid programs and subpopulations. Areas of focus include Population Health, Social Determinants of Health, Health Equity, Care Management/Coordination, Quality Improvement, Behavioral Health, Interoperability, Long-Term Services and Supports, Home and Community Based Services, and Medicaid and Medicare Integration.
Key responsibilities include:
o Research and assess prospective Medicaid growth markets. Gather key information on market and regulatory landscape and translate federal and state policy to discern impacts to Humana’s clinical operating model.
o Lead cross-functional teams of growth partners and health plan leaders to design high-impact, innovative, and competitive population health and clinical programs, models, partnerships, and initiatives for upcoming growth opportunities.
o Coordinate operational teams to translate state contract requirements, CMS regulations, market intelligence, and industry best practices into a viable target operating model.
o Develop project plans and roadmaps, driving timely completion of deliverables by cross-functional project team.
o Track project status and report on progress to leadership.
o Participate in the proposal development process. Provide content and recommendations to help shape responses to state Medicaid procurements and clearly articulate Humana's model.
o Document and clearly communicate operating model features to relevant teams to support proposal development and transition to implementation.
Required Qualifications
o Bachelor’s Degree
o 5+ years’ experience in a Medicaid Managed Care Organization or 5+ years’ experience in strategy consulting supporting Medicaid clinical strategy, population health management, or business development.
o Experience and understanding of the Medicaid ecosystem and managed care health services operations.
o Business development/proposal and/or implementation experience within Medicaid Managed care.
o Experience leading cross-functional teams to design a strategy and/or product.
o Strong problem-solving ability (i.e. adept at research and generating creative solutions)
o Ability to operate in a fast-paced environment under tight deadlines and in ambiguous situations.
o Highly organized and analytical with a strong attention to detail.
o Advanced Proficiency in Microsoft Office Products (i.e. Word, Excel, PowerPoint, Visio).
o Adept at quantitative and qualitative research.
o Excellent verbal and written communication and presentation skills.
Preferred Qualifications
o Master’s Degree in Public Health, Social Work, or Health Administration programs.
o MBA programs with a specialization in Healthcare Management.
o Project Management and Process Improvement qualifications.
Additional Information
Travel: Anticipate up to 10%
(as defined by tri-annual onsite Leadership and/or Team meetings)
Work at Home Criteria
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:
Interview Format
As part of our hiring process for this opportunity, we will use an interviewing technology called HireVue to enhance our hiring. HireVue allows us to quickly connect and gain valuable information from you about your relevant experience at a time that is best for your schedule.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours
40Pay 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.
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: 03-23-2026
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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.