Director of Care Management Strategy

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

The Director, Strategy Advancement will play an important role within Trend & Clinical Innovation at Humana to define, prioritize and execute on care management-focused initiatives to identify clinical interventions to improve cost of care and clinical outcomes, identify efficiencies, and improve member experience.

The role will provide data-based strategic direction to identify and address new opportunities for engagement from clinical and non-clinical members of our care team at key moments of influence can improve the quality of our members’ care and their health. The Director will be a collaborative thought partner and strategic support to the internal Care Management operations team and its leaders. The focus of the role will be on developing Humana Care Management pipeline of initiatives to reduce avoidable medical cost and achieve measurable ‘Trend’ savings; and on increasing the impact of Humana Care Management on Stars gap closure for clinical and care coordination measures.  

Key Responsibilities

• Using data analysis, external market / competitive best practices, and academic / scientific publications, and other sources to identify opportunities to reduce medical costs ("Trend opportunities") among Humana's Medicare population -- including but not limited to reducing preventable hospitalizations, non-emergent ER visits, and readmissions

• Developing financial analysis to determine the economic value of initiatives; developing a budget and request for funding as needed

• Developing and maintaining a robust Trend pipeline

• Designing pilot programs to test new Trend opportunities, including working developing creative solutions to IT and operational constraints

• Making persuasive presentations to senior executives about the progress of Trend initiatives

• Reviewing academic literature about best practices in Care Management and Care Delivery and making connections with leaders in the field

• Demonstrating an understanding and interest in statistical methods of quantifying the value of clinical activities, including Randomized Controlled Trials, propensity matching, predictive algorithms

• Partnering with functions inside Humana to design and launch clinical initiatives

• Building relationships with Risk Providers and applying their feedback to Trend initiatives

• Soliciting feedback from member-facing associates and channels on new Trend opportunities and value of existing Trend opportunities

• Using creative methods to develop a 'culture of Trend' within Humana at Home

• Define KPIs to measure the impact of Trend initiatives

• Creative problem solving to determine how to deploy innovative clinical models in highly regulated and Compliance-focused environments like Humana's Special Needs Plans

• Leading a team of associates to perform the above functions

Use your skills to make an impact
 

Role Essentials

• 3+ years of full-time strategy consulting experience with a leading management consulting firm, and/or strategy consulting experience outside of a consulting firm (e.g., healthcare organization); 5-7+ years of total work experience requiring consulting related skills/capabilities

• 3 or more years of management experience

• Ability to interpret and leverage data and analytics to improve strategy and make recommendations

• Strong problem-solving skills and the ability to perform complex qualitative and quantitative analysis

• Experience leading cross-functional group of leaders/teams and initiatives

• Proven skills influencing others and a track record of success leading through ambiguity

• Demonstrated ability to articulate ideas effectively in both written and oral forms with ability to flex to different audiences, including senior leadership

Role Desirables

• Master’s degree

• Care management/population health

Additional Information

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.

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 required; 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.

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.

 

$168,000 - $231,000 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.Application Deadline: 04-24-2026

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.

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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.