Strategy Advancement Advisor, UM and CM
3 days ago
Join Humana's Utilization Management (UM) & Care Management (CM) Strategy team as a Strategy Advancement Advisor and apply your strategic thinking and analytical skills to drive business transformation. You will lead complex, cross-functional initiatives to improve clinical quality, cost management, and member and provider experiences. Working alongside a high-performing, multi-disciplinary team, you'll leverage data and insights to develop, recommend, and execute impactful strategies in close partnership with senior stakeholders across the enterprise.
This role is ideal for candidates with strong strategic and analytical skills who thrive on delivering measurable impact. Success in this position requires a collaborative mindset, an ability to partner across functions to develop and implement high-value strategies, and a curiosity for uncovering insights in data to drive business improvements.
The Strategy Advancement Advisor, UM & CM Strategy will lead priority initiatives that may cut across utilization management, care management and other areas of the business including claims, product/IT, legal and compliance, etc. As part of this leadership, the Strategy Advancement Advisor will analyze complex problems using data and insights from internal and external sources, work collaboratively across teams and produce recommendations/plans to advance our clinical quality, cost and experience objectives.
In this role you will:
- Collaborate effectively with senior stakeholders and lead cross-functional teams to define opportunities, present findings, build cross-organizational alignment, and implement strategic initiatives.
- Evaluate and track performance of initiatives across UM and CM portfolio based on clinical (trend, Stars) and operational efficiency value.
- Oversee the planning, development, and implementation of tools and dashboards to support continuous performance monitoring and informed decision-making throughout project completion.
- Manage competing priorities and plan path to completion for medium to large enterprise efforts and initiatives including Management Team and Board requests.
- Bring expertise or identify subject matter experts to analyze and synthesize information, develop insights and produce recommendations based on company and external data analysis.
Required Qualifications
- Bachelor's degree.
- 5 or more years of consulting, strategy development, commercial and/or strategic planning or business strategy experience.
- Healthcare experience.
- Strong analytical experience being able to synthesize data and develop a methodology to help bring strategies together and present on those strategies.
- Microsoft Excel modeling & PowerPoint presentation skills.
- Experience translating ambiguity into structured framework and/or processes for analysis.
Preferred Qualifications
- Master's degree.
- Experience leading cross-functional groups of leaders/teams.
Additional Information
- Workstyle: remote, work from home
- Work Location: Louisville, KY or Washington D.C. area preferred
- Travel: quarterly travel anticipated
- Typical work days/hours: Monday – Friday, 8:00 am – 5:00 pm EST
WAH Internet
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.
HireVue
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. HireVue 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
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 will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$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:
About usHumana 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.
-
Strategy Advancement Advisor
6 days ago
Remote, Oregon, United States Humana Full time $115,200 - $158,400 per yearBecome a part of our caring community and help us put health firstThe Strategy Advancement Advisor provides data-based strategic direction to identify and address business issues and opportunities. Provides business intelligence and strategic planning support for business segments or the company at large. The Strategy Advancement Advisor works on problems of...
-
Advisor – Advanced Protection Testing
5 days ago
Remote, Oregon, United States Quanta Technology Full time $120,000 - $180,000 per yearQuanta Technology is an independent technology, consulting, and testing company providing business and technical expertise along with advanced methodologies and processes to utilities and others in the power and energy industries. Our mission is to provide unparalleled value to our clients in every engagement across the value chain by using advanced software...
-
Tax Accountant/Tax Advisor
1 day ago
Remote, Oregon, United States Bookkeeping and Management Systems, Inc. Full time $110,000 - $150,000 per yearCompany Overview is a fast-growing tax, accounting, and consulting firm that was founded with the purpose of helping individuals and small businesses reach their financial goals. Helping our clients thrive for more than 40 years, is a tech-savvy, remote-work-friendly, modern firm looking for power performers to enhance our culture. We take pride in...
-
Clinical Compliance Program Manager
3 days ago
Remote, Oregon, United States WellSky Full time $80,000 - $120,000 per yearThis job is responsible for ensuring compliance with WellSky's Utilization Management and Quality Improvement Program by serving as a clinical expert on state and federal regulations. The scope of this job includes analyzing and presenting data to establish best practices across post-acute health care settings, including LTACHs, IRFs, SNFs, and Home Health...
-
Cloud Sales Advisor
5 days ago
Remote, Oregon, United States World Wide Technology Full time $80,000 - $150,000 per yearQualifications:Candidates must have a successful track record of selling in the Public Sector or Healthcare verticals.Strong Cloud technical acumen.Understanding the technical challenges and demands of Cloud solutions.Ideal experience includes consultative solution.Experience with Azure, AWS and GCP preferred.Strong skills in developing new relationships...
-
Utilization Management Nurse
23 hours ago
Remote, Oregon, United States Integra Partners Full time $60,000 per yearIntegra is looking for a LPN/LVN experienced in the managed care payor environment to perform pre-service and post-service utilization reviews and appeals for DMEPOS. This individual will play a key role in collaborating with our Medical Director to perform benefit and medical necessity reviews and appeals within an NCQA-compliant UM program.Salary:...
-
Associate Vice President, Wealth Advisor
1 day ago
Remote, Oregon, United States Farther Full time $100,000 - $200,000 per yearCompany DescriptionFarther is a rapidly growing RIA that combines expert advisors with cutting-edge technology - delivering a comprehensive, tailored wealth management experience.Farther's founders are leaders and innovators from the private wealth industry who possess a unique blend of traditional wealth management, fintech, and technology production...
-
Product Strategy Senior Advisor
6 days ago
Remote, Oregon, United States The Cigna Group Full time $116,600 per yearJob Description:This is a management position where the candidate should have documented development experience in communication systems that involve Customer Data Platform (CDP) and Content Management System (CMS) technologies. This person will have an extensive background in managing a team focused on developing emails, SMS, and Push communications,...
-
Private Wealth Advisor
5 days ago
Remote, Oregon, United States Alpha Zero Wealth Full time $70,000 - $120,304 per yearLocation: Hybrid (Boca Raton, FL or Remote - U.S. Based)Employment Type: Full-TimeAbout Alpha Zero:Alpha Zero is a fast-growing, modern Registered Investment Advisory (RIA) firm redefining what wealth management looks like for elite performers. We specialize in serving professional athletes, entertainers, and high-net-worth individuals across the sports and...
-
Automation Program Advisor
1 day ago
Remote, Oregon, United States Accelirate Inc. Full timeAutomation Program AdvisorHow would you like to help the world's largest companies transform the way they work via automation allowing their team members to achieve their full potential? Helping customers' team members achieve more than they ever have by automating the day-to-day and focusing on driving business to a higher level.Our UiPath Automation...