The Senior Program Delivery Professional for IHWA is responsible for overseeing and advancing key initiatives that drive organic provider capture following an IHWA visit. This position plays a vital role in enhancing organic performance, supporting improved member care outcomes, and ensuring thorough and accurate documentation.
Key responsibilities include monitoring program activities, leading efforts to optimize provider participation, and applying expertise in causal analysis and provider office workflows. The role requires collaboration with department leaders to review, interpret, and communicate program results, as well as to inform and influence departmental strategy.
The successful candidate demonstrates the ability to make independent decisions on moderately complex to complex technical matters related to project components. The position is characterized by a high degree of autonomy, allowing for significant discretion in determining objectives and methods for assignments.
Key Responsibilities:
Prioritizing member care outcomes by identifying opportunities to share member data with various provider types to drive complete and accurate documentation by addressing conditions identified during IHWA visits.
Analyze performance and claims data to monitor and inform strategic decisions.
Generate innovative ideas and solutions to increase provider engagement and drive organic performance.
Collaborate with cross-functional teams to advance provider insights into IHWA visit and diagnosis data.
Leverage experience with provider front end and backend operations, workflows, and systems to inform best practices and effective delivery.
Strong cause and effect analytical skills to monitor results, identify trends, and recommend actionable advancements.
Take initiative as a self-starter and proactively seek opportunities to improve program effectiveness.
Required Qualifications:
Minimum three, (3) years of experience in root cause analysis, inner working of provider office and systems, or risk adjustment.
Proven ability to compare, read, and report on claims data.
Proven ability to conduct causal analysis and apply findings for program monitoring and improvement.
Passion for continuous learning and process excellence.
Excellent collaboration, communication, and stakeholder management abilities.
Experience with managing and monitoring successful and impactful projects.
Futuristic and broad thinker with attention to detail and downstream impacts.
Preferred Qualifications:
Bachelor’s or advanced degree in Healthcare Administration or related field.
Python, SQL, Databricks, or Power BI experience.
Risk adjustment background or knowledge.
Experience in provider office environments and familiarity with provider systems (e.g., Epic, Compass).
Strong understanding of provider networks, contracting, and service fund.
Workstyle: Open for Hybrid or Remote Work at Home
Location: U.S.
Schedule: 8:00 AM - 5:00 PM Eastern Time Monday through Friday
Travel: occasional onsite as business needs require.
Work at Home Guidance 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. 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.
SSN Alert 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.
Interview Format 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.
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: 01-08-2026
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.