Population Health Strategy Lead

The Population Health Strategy Lead at Humana, based in Sullivan's Island, SC, focuses on enhancing care quality and outcomes while managing costs for specific populations. Responsibilities include identifying health needs, advising executives on strategies, developing clinical insights, and implementing population health initiatives. The role requires collaboration with various teams to address healthcare disparities and improve community health outcomes, necessitating a Bachelor's degree and five years of relevant experience.
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The Population Health Strategy Lead is responsible for improving the quality of care and outcomes while managing costs for a defined group of people. The Population Health Strategy Lead works on problems of diverse scope and complexity ranging from moderate to substantial.

The Population Health Strategy Lead identifies health needs such as chronic diseases or disabilities, or the health needs of the underserved. Advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, uses independent judgment requiring analysis of variable factors and determining the best course of action.
• Develops, in conjunction with the Center for Equitable Population Health team (CEPH), clinical business intelligence and population health insights. Develops market strategies and innovative solutions in collaboration with CEPH and South Carolina market team
• Collaboratively design efforts addressed at improving health outcomes, reducing disparities, and improving cultural proficiency with other SCHHS-contracted managed care organizations to have a collective impact for the population and that lessons learned are incorporated into future decision-making
• Partners with centralized accreditation team to ensure contractually required market NCQA Accreditations.
• Oversees the Plan's strategic design, implementation, and evaluation of population health initiatives based on a deep understanding of scientific population health principles
• Creates evidence‐based, scalable, and financially sustainable population health solutions
• Develops and deploys the community engagement and investment strategy to support market goals and initiatives.
• Collaborates with Humana leaders in developing and implementing strategic initiatives to support an organizational workforce and culture that is inclusive and respectful of the various backgrounds reflected in our Enrollees and their communities.
• Helps assure the plan addresses healthcare disparities and ensures access to and the delivery of services to all Enrollees
• Identifies health disparities, and works with our communities, partners, and providers to improve health outcomes and to achieve a collective impact for the population
• Listens, and gives voice to, emergent issues creating barriers to access to care, healthcare disparities within the local healthcare community, their impacts on healthcare quality, outcomes, healthcare costs and access to care for underserved and marginalized communities
• Leverages all available data to provide meaningful reporting to internal and external committees on quality metrics across the plan, network and service delivery areas to ensure consistent standards across the state.

Required Qualifications

Use your skills to make an impact
• Bachelor’s Degree in nursing, public health, social work, health services research, health policy, information technology, or other relevant field
• Minimum five (5) years of progressively responsible professional experience in population health, service coordination, ambulatory care, community public health, or quality improvement
• Understanding of Social Risk Factors and their impact into health outcomes
• Ability to analyze data and make data-driven recommendations for quality improvement
• Excellent interpersonal skills; ability to develop effective relationships with a broad array of people internally and externally, including community partners, and communicate strategic goals and initiatives
• Experience with program planning, implementation, and evaluation
• Ability to take personal initiative and work independently, as well as part of a team
• Proficiency in Microsoft Office suite

Preferred Qualifications
• Master’s Degree in nursing, public health, social work, health services research, health policy, information technology, or other relevant field
• Familiarity with NCQA Accreditation requirements for Population Health Management and Health care standards
• Demonstrated experience leading initiatives addressing the social determinants of health
• Familiarity with social risk factors screening tools such as AHC or PRAPARE
• Experience implementing social need referral platforms
• Experience working with and addressing the needs of Medicaid members, preferably in a managed care setting.

Additional Information

Workstyle: Remote Work at Home

Location: Preferred South Carolina

Schedule: Monday through Friday 8-5 Eastern Time

Travel: 25% as needed to meet for business needs

Work At Home Guidance To Ensure Home Or Hybrid Home/Office Associates’ Ability To Work Effectively, The Self-provided Internet Service Of Home Or Hybrid Home/Office Associates 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
• Associates 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 associates 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

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.

$104,000 - $143,000 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 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.