Experience Inc. Jobs

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

The Program Delivery Lead strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Program Delivery Lead works on problems of diverse scope and complexity ranging from moderate to substantial.

Location: remote (If in driving distance to Louisville office, role will be hybrid which is a combination of in office and work at home)

Apply in-depth and broad knowledge of HEDIS measures to develop strategy and implement comprehensive solutions to drive overall Stars performance

• Accountability for performance and operational excellence of comprehensive programs to improve Star ratings

• Partner with multiple analytics teams to develop, prioritize, deliver, and measure solutions

• Proactively engage the right stakeholders to anticipate headwinds and identify gaps, looking ahead to anticipate pivots and action needed

Provide insights and identify new opportunities for improvement through data analysis of variable factors to determine course of action

• Ability to make recommendations based on reporting and monitoring by contract, region, provider and aggregate performance, identifying where things are going well and why, as well as where things need to improve and how

• Cross-collaboration with performance management team to interpret and deliver key recommendations to achieve Stars goals

Conduct audits of all data collection and processes to ensure operational excellence across initiatives

• Create standard operating procedures, document data collection, and establish processes for audit and quality control

• Identify gaps and new opportunities to improve performance

Support key functions with strategic and analytical thinking

• Requires a general understanding of Stars operations and ability to effectively communicate the Stars story

• Knowledge of the technical specifications and codes within attributed value sets

• Detail oriented and willing to learn the more minute parts of HEDIS measures and gap closure processes with limited guidance and direction

• Use problem solving skills to resolve issues and make decisions in a fast pace, complex, ever-changing environment

• Understand campaign development to provide insights for new concepts, technologies or processes

• Experience with market needs to provide insights to improve performance in key contracts and regions

• Understanding of or experience with clinical setting to advance provider first strategies, influence member interventions and identify new opportunities to impact

Use your skills to make an impact

Required Qualifications

• Bachelor’s Degree or equivalent work experience

• 8+ years of operations experience

• 2+ years of program management experience

• 2+ Medicare Stars knowledge or experience

• Superb communication skills, written and verbal

• Experience leading special projects and producing metrics, measurements and reports

• Proficiency in interpreting data trends and applying to operations

• Comfortable working independently to accomplish components of a larger program

• Strong organizational and time management skills

Desired Qualifications

• HEDIS experience

• Master’s degree

• Clinical experience

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: 01-30-2025

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 veteran status. 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.

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.