Care Management Strategy Lead

Humana
Trenton, NJ
**Become a part of our caring community and help us put health first** Are you a big picture thinker who likes to solve problems and set strategy? Are you interested in directly impacting care management services that help our members lead healthier, independent lives? Are you passionate about improving the health outcomes for the Medicare Advantage population? If so, you may be the Care Management Strategy Lead that Humana's Care Management Strategy Team is looking for! Our team is a mission-driven organization supporting Humana members and their caregivers, by identifying and addressing member care needs to achieve the goal of positively impacting members and caregivers' quality of life. Humana's Care Management Strategy organization is focused on improving clinical outcomes and delivering on business priorities for the members we serve. Our Team partners with Care Management and other enterprise partner teams by employing a rigorous process to set specific business priorities and identify the greatest sources of value. The Strategy Advancement Advisor will drive strategy development by collaborating with a multi-disciplinary team to identify discrete opportunities for enhanced clinical outcomes, cost control, quality, and member experience. **_Responsibilities include the following:_** + Drive initiatives to analyze complex problems and issues related to care management using data and insight from internal and external sources with a focus on Stars performance and members served in care management programs. + Provide data-backed strategic direction to identify and address business issues and opportunities related to the high-needs Medicare Advantage and SNP (Special Needs Plan) populations that benefit from Humana's Care Management services. + Identify and operationalize opportunities to improve member health outcomes, member and care manager experience, clinical quality, Stars program performance and savings to medical costs. + Work with operational owners and key business partners to translate strategic recommendations into execution plans for end-to-end implementation. + Solve diverse and complex problems by bringing your own contributions while partnering with other key stakeholders from across the enterprise (clinical, quality, operations, analytics, enterprise Stars team and business). **_Success in this role will require the ability to:_** + Engage in an ambiguous problem solving and strategy setting. + Use data and insight from experts to identify the greatest opportunities in clinical outcomes, quality, cost, and experience for members in care management programs. + Communicate initiatives to audiences at all levels of the organization. + Lead cross-functional teams with an ability to influence without authority. + Give definition to discrete opportunities that are both impactful and achievable. + Forecast the value of key initiatives. + Work directly with cross-functional partners across the enterprise to create the execution model and roadmap for prioritized opportunities. **Use your skills to make an impact** **Required Qualifications** + Bachelor's degree with 6 or more years of relevant strategic work experience creating and driving cross-functional strategy OR Master's degree with 4 plus years of the same experience. + Experience interpreting and leveraging data and analytics to improve strategy and make recommendations, with strong problem-solving skills. + Experience completing analysis and modeling of data to drive qualitative and quantitative insights and recommendations for strategy advancement. + Experience leading cross-functional group of leaders/teams and initiatives. + Experience communicating effectively, both verbally and in writing, and adapting messaging for various audiences, including senior leadership. + Proven skills influencing others and a track record of success leading through ambiguity. + Proven organization, planning and prioritization skills to collaborate with multiple enterprise departments and stakeholders and the ability to execute within deadlines. + Competency with Microsoft Office suite (PowerPoint, Excel, etc.). **Preferred Qualifications** + Consulting firm experience in strategy consulting or advising in a business strategy, clinical and/or operational area. + Advanced degree in relevant field or MBA. + Strategy Management consulting experience + Exposure or experience with clinical care delivery and interventions and/or care management. + Prior experience or exposure to Medicare Stars Program. **Additional Information** + **Workstyle:** remote, work from home. + **Travel:** as needed for meetings, up to 20% + **Typical workdays/hours:** Monday - Friday, 8:00 am - 5:00 pm EST **WAH Internet** 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 recommended; 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. **HireVue** 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** 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. $115,200 - $158,400 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: 11-16-2025 **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 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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our
Posted 2025-11-12

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