This role provides end-to-end oversight of the DSNP Health Home program, ensuring smooth operations and compliance. Key responsibilities include tracking program activity, maintaining accurate policies and procedures, and supporting payer partnerships through meeting coordination and presentation development. The position also leads training efforts for internal teams and external stakeholders.
Collaboration is essential, working with partners to resolve plan issues and supporting member communications. The role manages system access for state platforms, oversees compliance projects, and ensures timely updates to provider manuals and websites. Additional duties include maintaining contact lists, handling data files, and providing backup support for program communications.
The position will provide support to meet expectations in the 2026 and future SMACs including but not limited to issuing required notices to long-term services and supports when criteria is met and may provide coordination support with complex hospital discharge cases. Overall, this role combines operational management and compliance oversight support to keep the DSNP programs running effectively.
Additional duties as assigned.
Required Qualifications
Bachelor’s degree, preferably in healthcare administration, public health, health informatics, social services, nursing, business administration or other related field.
3 years of experience in managed care, DSNP programs, health home operations, network management, provider relations, or work with state health agencies/community organizations.
In-depth knowledge of CMS and state regulations for DSNP, Medicare/Medicaid, and related programs.
Strong organizational and communication skills with the ability to manage diverse stakeholders.
Skilled in planning, preparation, and delivering presentations with proven ability to handle multiple projects and meet deadlines with attention to detail.
Proficiency in healthcare systems and Microsoft Office Suite.
Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
Preferred Qualifications
Master's Degree, preferably in healthcare-related health field.
Experience with project management tools and methodologies.
Advanced knowledge of CMS compliance audits and state regulatory processes.
Familiarity with payer relations and contract management.
Strong data analysis and reporting skills for program performance metrics.
Experience developing training programs and leading stakeholder education sessions.
Demonstrated ability to lead cross-functional teams and drive process improvements.
Additional Information
Work At Home / Internet Statement:
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 Statement: 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.
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: 01-09-2026
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.