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

The Director, Medical Cost Management Operations leads governance of the holistic Medicare Advantage trend management function, providing strategic direction to identify and address issues and opportunities across all elements of the Medical Cost Management operating model. The role requires an in-depth understanding of how organizational capabilities interrelate across key enterprise stakeholders and provides oversight to all communications, operating cadence and process improvement initiatives to deliver meaningful operating efficiencies, improved stakeholder experience and optimized Medical Cost Management outcomes.

This leader leverages experience in organizational effectiveness to analyzes 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 that deliver meaningful value to the organization. Key areas of responsibility include:

• Leads executive-level communications and reporting to deliver clear and comprehensive insights to stakeholders at all levels of the organization on a timely basis
• Orchestrates centralized stakeholder communications to strengthen relationships, engagement and outcomes with Medical Cost Management team partners across the enterprise
• Ensures the organization’s complex operating cadence is streamlined and highly productive; continuously adapting to top business priorities and needs
• Designs and manages centralized management tools that drive stakeholder accountability and reduce administrative friction
• Ownership of organization’s key performance indicator reporting – both tracking to ensure responsive and proactive management of important business drivers and oversight of actions required to ensure targeted outcomes are achieved
• Leads discovery and design initiatives that drive always-on process improvement for the Medical Cost Management team. Areas of focus will include opportunities to improve partner engagement and experience, drive operating efficiencies / reduce redundancies, and mechanisms to gauge and respond to feedback loops from stakeholders involved in Medical Cost Management

Use your skills to make an impact

Required Qualifications

• Bachelor's degree in healthcare, business, or related field
• 8+ years of leadership experience in healthcare industry
• Proven track record of driving operational performance improvement.
• Excellent verbal and written communication skills with experience creating and delivering executive level presentations
• Strong collaboration and interpersonal skills to influence, facilitate and enhance performance within a cross-functional environment; effective at leading diverse personalities and all levels of leadership
• Self-motivated and able to work independently in a fast-paced environment
• Excellent time management, organizational and prioritization skills; strong attention to detail
• Proven experience working with senior leaders within Humana
• Experience in creating, and executing on, an enterprise scale business development strategic plan
• Must be passionate about contributing to an organization focused on continuous improvement

Preferred Qualifications

Additional Information

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 decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$149,800 - $206,100 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities.

About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.