Innovation Portfolio Strategy Advisor

📋 Description

• • As an Innovation Portfolio Strategy Advisor at Humana, you will be instrumental in shaping and executing the product strategy for assigned behavioral health products within the company's portfolio. Reporting to a Behavioral Health portfolio director, your primary role is to translate high-level strategy into tangible product delivery, ensuring that innovative solutions are brought to life to enhance the quality and accessibility of behavioral health services across Medicare Advantage (MA) and Medicaid (MCD) lines of business. This pivotal position demands a strategic thinker with a strong operational mindset, capable of navigating complex healthcare landscapes and driving impactful change.
• • Your day-to-day responsibilities will be multifaceted and critical to the success of Humana's behavioral health initiatives. A significant part of your role will involve meticulous Network Access Monitoring. You will be tasked with establishing and maintaining real-time insights into the general behavioral health (BH) network's access, as well as specialized areas such as Substance Use Disorder (SUD), Autism Spectrum Disorder (ASD), and Dementia. This comprehensive monitoring will span across both MA and MCD populations, providing a clear picture of where access gaps exist and where improvements are most needed.
• • Complementing network access, you will also focus on Provider Performance Measurement. This involves developing, implementing, and managing robust provider scorecards and tiering systems. These tools will be essential for assessing and differentiating provider performance and quality, enabling Humana to identify high-performing partners and areas for development. This data-driven approach ensures that Humana is working with providers who deliver exceptional care and outcomes.
• • A core component of your role will be extensive Cross-functional Collaboration. You will act as a key liaison, partnering closely with MA and MCD network teams, the MA network adequacy team, and market leadership. By leveraging network data and provider performance metrics, you will drive continuous improvement in network quality and operational efficiency. Your ability to foster strong working relationships across diverse teams will be paramount to achieving shared goals.
• • You will also be at the forefront of driving Value-Based Initiatives. This includes launching and leading Pay-for-Performance (P4P) projects specifically for MA providers. Furthermore, you will actively support and expand ongoing P4P programs within MCD, encouraging provider engagement and ultimately driving improved member outcomes through performance-based incentives.
• • Finally, your role will encompass critical Provider Relationship Management. You will be responsible for managing Joint Operating Committees (JOCs) and sustaining ongoing, productive relationships with large provider groups. Serving as the primary point of contact for issue resolution, troubleshooting, and the development of strategic partnerships, you will ensure that Humana's provider network is strong, collaborative, and aligned with the company's mission.
• • The team you will be joining is dedicated to advancing Humana's commitment to providing accessible, high-quality behavioral health services. This group operates within a dynamic and evolving healthcare environment, focused on innovation and member well-being. You will be part of a supportive community that values collaboration and strives to make a meaningful difference in the lives of those served.
• • In this role, you have a unique opportunity to deepen your expertise in managed care, specifically within the critical domain of behavioral health. You will gain invaluable experience in network strategy, provider performance management, and the implementation of value-based care models. The insights and skills developed here will position you for significant career growth within Humana or the broader healthcare industry, allowing you to lead impactful initiatives and contribute to the future of healthcare delivery.
• • This position offers the chance to directly influence the accessibility and quality of care for millions of individuals relying on Humana's services. By driving strategic initiatives and fostering strong provider partnerships, you will play a key role in achieving Humana's mission of helping its members achieve their best health. Your work will have a tangible impact on member outcomes and the overall effectiveness of behavioral health services.