Senior Strategy Professional

Become a part of our caring community and help us put health first

The Senior Strategy Advancement Professional will support the design, implementation, and advancement of strategic initiatives within the Utilization Management (UM) function. This role is responsible for leveraging data-driven insights, industry best practices, and cross-functional collaboration to optimize UM processes, improve clinical outcomes, and enhance member and provider experiences.

The Senior Strategy Advancement Professional helps develop and execute strategies to advance UM program effectiveness and efficiency in alignment with organizational goals and regulatory requirements. Analyze UM data, identify trends, and recommend actionable solutions to address opportunities for process improvement and cost management. Collaborate with clinical, actuarial, operations, and compliance teams to ensure integration of UM strategies across business units. Monitor the performance of UM initiatives using defined metrics and prepare regular reports and presentations for leadership.

Participate in cross-functional work groups, supporting project management and change management efforts. Maintain current knowledge of industry regulations, accreditation standards, and emerging trends in utilization management. Support the organization’s commitment to talent development, diversity, equity, and inclusion by engaging in ongoing learning and development opportunities.

• Bachelor’s degree in healthcare, business, actuarial science, or a related field;
• Minimum of 3 years of experience in utilization management, healthcare strategy, or a related field.
• Demonstrated ability to use data analytics and project management principles to drive strategic initiatives.
• Strong communication, collaboration, and organizational skills.
• Familiarity with relevant regulations and accreditation standards (e.g., NCQA, URAC).

• Experience in actuarial analysis, healthcare quality improvement, or program management.
• Advanced degree or professional certification (e.g., RN, LPN, MBA, PMP, ASA/FSA).
• Experience with designing and implementing clinical documentation systems

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

• Health benefits effective day 1
• Paid time off, holidays, volunteer time and jury duty pay
• Recognition pay
• 401(k) retirement savings plan with employer match
• Tuition assistance
• Scholarships for eligible dependents
• Parental and caregiver leave
• Employee charity matching program
• Network Resource Groups (NRGs)
• Career development opportunities

As part of our hiring process for this opportunity, we will be using an interviewing technology called Hire Vue to enhance our hiring and decision-making ability. Hire Vue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Humana values personal identity protection. Please be aware that applicants may be asked to provide your Social Security Number, if it is not already on file. When required, an email will be sent from  with instructions on how to add the information into your official application on Humana’s secure website.

Travel:
While this is a remote position, occasional travel to Humana's offices for training or meetings may be…