Advisor, Medicaid Provider & Network Strategy

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 The Advisor, Medicaid Network Strategy will be accountable for leading the development of Humana Healthy Horizon’s (Medicaid) network development market entry strategy for its Medicaid growth markets. This strategist will lead data-driven research oriented strategic advisement in the development of strategies that produce robust, adequate, and accessible networks. The Advisor will also drive the development of competitive & innovative network strategies to support request for proposals (RFPs) and market entry. Such strategies include, but are not limited to network development, healthcare delivery transformation, access to care, and alternative sites of care. The position requires an in-depth understanding of how organizational capabilities interrelate within the enterprise to develop and execute network strategy. This position exercises strong project management skills, analysis of variable source information, independent judgment, and decision making on complex issues related to the job duties and related tasks. Up to 10% travel is expected for this role.

We are seeking an experienced strategist with a track record of evaluating and synthesizing multiple sources of qualitative and quantitative data to define network priorities, determine strengths & gaps, and build solutions. Excellent interpersonal, organizational, written, and oral communication and presentation skills with proven experience writing and delivering presentations to members of the management team and internal business partners will be critical in this role.

Key responsibilities for this role include:

• Leads market network discovery research and analysis of inputs that supports the creation of a network development strategic plan that will drive Humana's network market entry strategy decisions.
• Works cross functionally to seek consult and provide advisement on a proposed network strategies and timeline based on analysis of internal and external source data and managed care program requirements.
• Drives market competitor analysis and the evaluation of existing managed care requirements to assess gaps in Humana’s pre-rfp & market entry network strategy.
• Develops & recommends network strategies based on insights from the discovery research conducted to support the network development strategic plan of assigned Medicaid pipeline markets.
• Leads network workstream meetings, including content creation from the market development kick-off through the initiation of the network build.
• Presents to Medicaid senior leadership regular progress updates on network strategy in assigned markets.
• Serves as the market subject matter expert to assist business development in developing provider network request for proposal (RFP) responses.

Use your skills to make an impact
 

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