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Capture Lead, Medicaid Clinical & Population Health Strategy
Humana - Baton Rouge, LA
posted 2 months ago
About the position
The Capture Lead, Clinical & Population Health Strategy at Humana Healthy Horizons is responsible for leading initiatives that develop and execute strategies to position the company for growth opportunities in the Medicaid sector. This role involves collaboration across various departments to translate state requirements into actionable clinical strategies, optimizing clinical operating models for Medicaid health plans, and supporting the strategic direction of Humana's Medicaid products and capabilities.
Responsibilities
- Research and assess prospective new markets, gathering key information on market and regulatory landscapes.
- Coordinate operational teams to translate contract requirements, CMS regulations, and market intelligence into a viable target operating model.
- Lead cross-functional teams to design innovative and competitive clinical programs and initiatives for growth opportunities.
- Develop project plans and roadmaps, ensuring timely completion of clinical deliverables by project teams.
- Track project status and report on progress to leadership.
- Participate in the proposal development process, providing content and recommendations for state procurements.
Requirements
- Bachelor's degree with a strong academic record.
- 5+ years of experience in a Medicaid Managed Care Organization focusing on Medicaid clinical strategy and population health management.
- 5+ years of experience leading cross-functional teams to design and implement Medicaid clinical or population health management strategies.
- 5+ years of experience supporting Medicaid managed care health services operations and business development lifecycle.
- Strong problem-solving ability with quantitative and qualitative research skills.
- Ability to operate in a fast-paced environment under tight deadlines.
- Highly organized and analytical with attention to detail.
- Advanced proficiency in Microsoft Office products (Word, Excel, PowerPoint, Visio).
- Excellent verbal and written communication and presentation skills.
Nice-to-haves
- Master's degree in public health or health administration.
- MBA with a specialization in Healthcare Management.
- Project Management and Process Improvement qualifications.
- Experience with dual eligibles and D-SNPs.
Benefits
- Competitive pay and comprehensive benefits package including 401k, Medical, Dental, Vision, and supplemental insurances.
- Tuition assistance and paid time off including personal holidays and volunteer time off.
- Short-term and long-term disability, life insurance, and paid parental and caregiver leave.
