Medicaid Clinical Delivery Model Strategy Advisor - Louisville OR Work at Home (WAH)

Humana - Louisville, KY3.7

Full-timeEstimated: $88,000 - $110,000 a year
EducationSkills
Description

The Strategy Advancement Advisor 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 Strategy Advancement Advisor works on problems of diverse scope and complexity ranging from moderate to substantial.
Responsibilities

The Strategy Advancement Advisor 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. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.

In addition the Strategy Advancement Advisor is responsible for the following:

Coordinate business partners and collaborate with Medicaid leadership to develop and adapt Humana's clinical delivery model.
Develop clinical strategies to exceed regulatory requirements and successfully position Humana’s Medicaid/LTSS/Dual products in the marketplace.
Gather key information on market and regulatory landscape in prospective new markets to inform product build.
Attend professional conferences to enhance knowledge and understanding.
Engage in stakeholder and provider/association level relationship development meetings in current and prospective new markets.
Translate state administrative code language and procurement requirements to understand state’s ultimate vision.
Define Humana’s clinical delivery model and translate into winning proposals.
Ensure compliance with all state and federal laws in development process.
Oversee project plans, project schedules, resource assignment matrixes, etc. at the outset of each bid.
Drive timely completion of internal/external deliverables by cross functional project team.
Track project status and report on progress to leadership.
Help develop materials for internal and external presentations and communications regarding Humana’s business goals, market strategy, policy, positioning, and outcomes in the Medicaid and Dual Eligible marketplace.
Required Qualifications

Bachelor’s Degree
1 - 3 years’ experience in a Medicaid or Medicare Managed Care Organization
1 - 3 years’ experience leading projects & cross functional teams
1 - 3 years’ consulting experience
Comprehensive knowledge of Microsoft Office Products (Word, Excel, PowerPoint, Visio)
Ability to operate in a faced paced environment under tight deadlines
Flexible scheduling (i.e. – occasional nights and weekends)
Preferred Qualifications

Master’s Degree
Bachelor’s Degree in Nursing (BSN)
3 – 5 years’ experience in Medicaid/LTSS Operations
3 – 5 years’ experience in Medicaid/LTSS Clinical or BH Programs
3 – 5 years’ experience in Medicaid/LTSS Strategy and/or Business Development
Project Management and Process Improvement qualifications
Additional Information

Role will include travel (10-20% of time)

Scheduled Weekly Hours

40