87 applicants

Company

Original Job Post

Humana · 3 days ago

Director of Utilization Management (UM) Cost of Care Strategy

Remote Kentucky

Full-time

Onsite

Director

$165K/yr - $227K/yr

3+ years exp

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Responsibilities

Conduct multi-pronged discovery on utilization management at Humana – past approaches & learnings at Humana, current initiatives & challenges, current & future industry dynamics, competitive landscape, etc.

Develop learning agendas and partner with analytical functions to rigorously study UM trends and outcomes, and leverage data and insight to continuously improve program outcomes

Assess where to play (e.g., highest value opportunity spaces) and how to win (e.g., tactics and capability requirements for opportunity capture) – develop strategic framework, conduct relevant quantitative analyses and feasibility assessments to prioritize highest value strategic initiatives

Collaborate with key partners across enterprise to co-develop strategies / priorities – working hand-in-hand with Clinical Operations and Market partners, ensuring connectivity into broader enterprise strategies and with broader clinical assets (such as Care Management and Pharmacy), informing strategies with data-driven insights from Analytics, Health Care Economics

Provide day-to-day leadership to drive progress and alignment

Solicit senior leader alignment on key decisions through executive-level presentations and discussion facilitation

Translate strategies into OKRs and tactical implementation plans for execution, in collaboration with key partners / stakeholders (e.g., technology, operational teams, provider experience, etc.); ensure joint prioritization of key operational imperatives

Provide leadership on defining & executing on relevant governance forums to support excellent operational execution & capability development

E.g., Stand-up or integrate into existing relevant governance forums to align on key decisions, track progress, escalate issues, and solicit support for operational execution of strategy

E.g., Develop & execute process to ensure appropriate stakeholders have had opportunity to inform, decide or veto key decisions

E.g., Determine key metrics and progress milestones to track against

E.g., Provide day-to-day leadership to drive progress and alignment

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Management ConsultingCorporate StrategyBusiness OperationsHealthcare IndustryAnalytic AcumenData AnalysisContinuous ImprovementCustomer ExperienceMicrosoft OfficeExcelPowerPointWordProblem-SolvingTeam LeadershipOrganizationCommunicationUtilization managementHumana teamsEnterprise interconnectednessInterpersonal

Required

Bachelor’s degree or higher

3-5+ years in management consulting, corporate strategy, business operations or equivalent experience in healthcare company

Prior experience in healthcare industry and project leadership

Team leadership experience as a people leader role will have individual contributors reporting into it

Proven organization, planning and prioritization skills to collaborate with multiple internal stakeholders concurrently (and potential also vendor partners); ability to operate on deadlines

Demonstrated analytic acumen, ability to leverage data to drive decision making and improve outcomes

Strong strategic acumen with focus on continuously improving outcomes and customer experience

Excellent executive-level communication skills and presentation skills, including developing compelling stories for executive audiences

Comprehensive knowledge of all Microsoft Office applications including Excel, PowerPoint, Word

Preferred

Deep understanding of Utilization Management

Deep understanding of Humana teams and enterprise interconnectedness

Benefits

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

Company

Humana

Glassdoor

3.8

Humana is a health insurance provider for individuals, families, and businesses.

Founded in 1964

Louisville, Kentucky, USA

10,001+ employees

http://www.humana.com

H1B Sponsorship

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2020 (107)