Director, Medicaid Trend Mitigation Strategy

Become a part of our caring community and help us put health first
 The Director, Medicaid Trend Mitigation Strategy provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for business segments or the company at large. The Director, Medicaid Trend Mitigation Strategy requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

The Director, Medicaid Trend Mitigation Strategy leads initiatives to analyze complex business problems and issues using data from internal and external sources. Brings expertise or identifies subject matter experts in support of multi-functional efforts to identify, interpret, and produce recommendations and plans based on company and external data analysis. Ensures that policies and procedures align with corporate vision. Selects, develops, and evaluates personnel ensuring efficient operation of the function. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into functions strategy. 

• Establishes and oversees Medicaid segment trend mitigation strategy (claims and revenue management) 

• Researches industry trends and standards to create best-in-class cost and revenue management program 

• Identifies nationwide opportunities for operational change within the segment and advises senior leaders on strategies 

• Builds strong relationships and partners across the enterprise (Actuarial, Claims, Clinical, Innovation, Network, Pharmacy, Revenue) 

• Leads cross-functional workgroups to mitigate nationwide trends 

• Establishes best practices for ongoing trend mitigation and clearly defined roles and responsibilities of all partners 

Use your skills to make an impact
 

Required Qualifications

• Bachelor’s degree 

• 8 or more years of experience 

• Strong communication skills 

• Ability to travel to annual meeting (other travel may be required based on business needs) 

• Must be passionate about contributing to an organization focused on continuously improving consumer experiences 

Preferred Qualifications

• Medicaid experience preferred 

• 8 or more years of healthcare experience preferred 

• Experience leading cross functional teams preferred 

• Visionary - embraces the big picture and translates into strategy; anticipates longer term business needs and prepares team to take on challenges 

• Effective Influencer 

• Emotional intelligence 

• Presence - comfortable with senior leaders and other functional areas 

Scheduled Weekly Hours

40

Pay 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.

 

$168,000 - $231,000 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 01-16-2025
About us
 Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.

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