Medicaid Strategy Lead

Medicaid Strategy Lead - Clinical and PopulationBecome a part of our caring community and help us put health first. The Medicaid Strategy Lead - Clinical and Population will lead initiatives to develop and execute strategy to successfully position Humana to capture growth opportunities and develop operating models. This role will work horizontally across the organization, coordinating with Medicaid and Medicare leadership and population health and clinical subject matter experts to synthesize, assess, and translate state requirements into actionable go-to-market clinical strategy. The Lead will consult with growth partners to design and optimize population health and clinical operating model blueprints for viable Medicaid health plans that meet the needs of state clients and populations served in target growth markets. Candidates will possess Medicaid managed care operations expertise and have experience in designing solutions for key Medicaid programs and subpopulations. Areas of focus include Population Health, Social Determinants of Health, Health Equity, Care Management/Coordination, Quality Improvement, Behavioral Health, Interoperability, Long-Term Services and Supports, Home and Community Based Services, and Medicaid and Medicare Integration.Key responsibilities include:Research and assess prospective growth markets. Gather key information on market and regulatory landscape and translate federal and state policy to discern impacts to Humana's operating model.Lead cross-functional teams of growth partners and health plan leaders to design high-impact, innovative, and competitive population health and clinical programs, models, partnerships, and initiatives for upcoming growth opportunities.Coordinate operational teams to translate contract requirements, CMS regulations, market intelligence, and industry best practices into a viable target operating model.Develop project plans and roadmaps, driving timely completion of deliverables by cross-functional project team.Track project status and report on progress to leadership.Participate in the proposal development process. Provide content and recommendations to help shape responses to state Medicaid procurements and clearly articulate Humana's product strategy.Document and clearly communicate operating model features to relevant teams to support proposal development and transition to implementation.Use your skills to make an impactRequired Qualifications:Bachelor's Degree5+ years' experience in a Medicaid Managed Care Organization or 5+ years' experience in strategy consulting supporting Medicaid clinical strategy, population health management, or business development.Experience and understanding of the Medicaid ecosystem, managed care health services operations.Pre-RFP proposal development/implementation within Medicaid Managed care.Experience leading cross-functional teams to design a strategy and/or product.Strong problem-solving ability (i.e. adept at research and generating creative solutions).Ability to operate in a fast-paced environment under tight deadlines and in ambiguous situations.Highly organized and analytical with a strong attention to detail.Advanced Proficiency in Microsoft Office Products (i.e. Word, Excel, PowerPoint, Visio).Adept at quantitative and qualitative research.Excellent verbal and written communication and presentation skills.Preferred Qualifications:Master's Degree in Public Health or Health Administration programs.MBA programs with a specialization in Healthcare Management.Project Management and Process Improvement qualifications.Additional Information:Travel: Anticipate up to 10% (as defined by tri-annual onsite Leadership and/or Team meetings)Work at Home Criteria: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.Interview Format:As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. Modern Hire 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.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours: 40Pay Range: $115,200 - $158,400 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.Application Deadline: 01-30-2026About 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.