Humana · 1 day ago
VP, Foundational Capabilities
United States
Full-time
Remote
Mid, Senior Level
5+ years expHumana is committed to putting health first, and they are seeking a VP, Foundational Capabilities to lead strategic initiatives focused on advancing Stars performance. This role involves leveraging technology and innovative strategies to enhance operational efficiency and ensure compliance with industry standards.
Health CareHealth InsuranceInsuranceVenture Capital
Responsibilities
Continuously monitor and analyze industry trends, CMS updates, competitor activity, and market dynamics that impact the Medicare Stars landscape
Develop and communicate insights to inform organizational strategy and ensure proactive responses to changes in the regulatory and competitive environment
Accountable for ensuring top executives are well informed and have the right information on competitive intelligence to make decisions, highlighting risks, opportunities, and recommended actions
Oversee strategy and integration of digital tools, automation, and artificial intelligence to enhance operational efficiency and support data-driven decision making
Evaluate, select, and implement innovative technology solutions that streamline Stars data capture, analytics and operational impact
Partner with IT, Digital and Experience teams to ensure emerging opportunities are integrated and feedback loop complete
Develop engagement models to enhance provider connectivity working closely with Interoperability and Provider Connection teams
Design emerging educational programs and resources that equip providers and members with actionable data, best practices, and compliance guidance
Establish feedback mechanisms to gather input and continuously improve partnership effectiveness
Serve as the primary liaison between internal teams, external partners, vendors, and regulatory agencies for Stars initiatives
Lead cross-functional workgroups to align priorities, share knowledge, and ensure accountability in delivering on Stars objectives
Manage long term strategic planning with strategic partners to ensure value realization and support long-term program success
Qualification
Required
Bachelor's Degree in Business Administration, Health Administration or a related field
Progressive experience in the health solutions industry, with emphasis on leading and managing teams
Prior Medicare/Medicaid experience
Knowledge of HEDIS/Stars and CMS quality measures
Prior managed care experience
Proficiency in analyzing and interpreting healthcare data and trends
Strong attention to detail and focus on process and quality
Excellent communication skills
Ability to operate under tight deadlines
Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred
Master's degree in business administration, Health Administration or a related field
5 or more years of Stars experience
Proven organizational and prioritization skills and ability to collaborate with multiple departments
PMP certification a plus
Six Sigma Certification also a plus
Experience with AI and emerging Digital/Technology solutions
Company
Humana
Humana is a health insurance provider for individuals, families, and businesses.
10001+ employees
H1B Sponsorship
Humana has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (282)
2024 (246)
2023 (284)
2022 (274)
2021 (212)
2020 (84)
Funding
Current Stage
Public CompanyTotal Funding
$13.07B2025-05-30Post Ipo Debt· $5B
2025-03-03Post Ipo Debt· $1.25B
2024-03-11Post Ipo Debt· $2.25B
Leadership Team
Jim Rechtin
CEO and President
Colin Drylie
Senior Vice President, Experience Transformation
Recent News
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