Innovation Portfolio Strategy Advisor

** Become a part of our caring community*
* The Innovation Portfolio Strategy Advisor reports to a Behavioral Health portfolio director and drives the product lifecycle for assigned products within that portfolio. You will accomplish the product strategy developed by the portfolio director by translating strategy into actual product delivery. The Portfolio Strategy Advisor works across departments to form colleague teams that can support overall delivery of a product, sets prioritization, maintains alignment of effort, and owns delivery.

The Innovation Portfolio Strategy Advisor is responsible for advancing Humana's behavioral health network quality and access across both Medicare Advantage (MA) and Medicaid (MCD) LOBs. This position will focus on developing and executing strategies to enhance provider performance, ensure true network access, and drive value-based initiatives that improve care quality and member outcomes.

** Key Responsibilities*
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** Network Access Monitoring:*
* + Establish and maintain real-time insights into general behavioral health (BH) network access and BH specialty areas access-including Substance Use Disorder (SUD), Autism Spectrum Disorder (ASD), and Dementia-across both MA and MCD.

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** Provider Performance Measurement:*
* + Develop, implement, and manage provider scorecards and tiering systems to assess and differentiate provider performance and quality.

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* Cross-functional Collaboration:

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* + Partner with MA and MCD network teams, MA network adequacy team, and market leadership teams to use network data and provider performance metrics for continuous improvement of network quality and efficiency.

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** Value-Based Initiatives:*
* + Launch and lead Pay-for-Performance (P4P) projects for MA providers. Support and expand ongoing P4P programs within MCD, driving provider engagement and improved member outcomes.

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** Provider Relationship Management:*
* + Manage Joint Operating Committees (JOCs) and sustain ongoing relationships with large provider groups. You will be the contact for issue resolution, troubleshooting, and strategic partnership development.

** Use your skills to make an impact*
* ** Role Essentials*
* + Bachelor's degree in healthcare, business, or related field

+ 7+ years' experience in network strategy, provider relations, or behavioral health management within a managed care setting

+ Skilled in developing strategic partnerships and engaging with internal and external stakeholders to support behavioral health initiatives

+ Proven ability to work with multiple stakeholders, lead cross-functional teams and implement strategic initiatives

+ Strong analytical skills, with experience in provider performance measurement and network adequacy

+ Demonstrated ability to articulate ideas effectively in both written and oral forms

** Role Desirables*
* + Master's degree

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Experience with value-based care and pay-for-performance models

+ In-depth knowledge of behavioral health provider networks for both MA and MCD populations

+ Ability to manage complex provider relationships and drive collaborative outcomes

** Additional Information*
* 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 required; 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.

Work at Home Requirements:
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 required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

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

** Scheduled Weekly Hours*
* 40

** Pay Range*
* The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay…