Program Delivery Lead

This is a fully remote position, open to applicants in California, +3 more states.

📋 Description

• Lead the product lifecycle for designated products within the behavioral health portfolio.

• Convert portfolio strategy into tangible product delivery.

• Assemble interdisciplinary teams to facilitate product delivery.

• Set priorities and ensure alignment of efforts.

• Take ownership of the delivery of assigned products.

• Enhance Humana’s behavioral health network quality and accessibility across Medicare Advantage and Medicaid sectors.

• Create and sustain real-time insights regarding access to the behavioral health network, including specialties in SUD, ASD, and dementia.

• Design, execute, and oversee provider scorecards and tiering systems.

• Collaborate with MA and MCD network teams, the MA network adequacy team, and market leadership teams.

• Initiate and manage Pay-for-Performance projects for MA providers.

• Support and grow P4P programs within MCD.

• Oversee Joint Operating Committees and maintain relationships with major provider groups.

• Act as a point of contact for issue resolution, troubleshooting, and developing strategic partnerships.

⛳️ Requirements

• Bachelor’s Degree.

• Over 8 years of experience in network strategy, provider relations, or behavioral health management within a managed care environment.

• Proficient in establishing strategic partnerships and engaging with both internal and external stakeholders to advance behavioral health initiatives.

• Demonstrated capability to collaborate with various stakeholders, lead cross-functional teams, and execute strategic initiatives.

• Strong analytical abilities, with experience in measuring provider performance and ensuring network adequacy.

• Proven ability to effectively communicate ideas in both written and verbal forms.

• Familiarity with value-based care and pay-for-performance models.

• Comprehensive understanding of behavioral health provider networks for both MA and MCD populations.

• Capacity to manage complex provider relationships and achieve collaborative outcomes.

• Minimum internet download speed of 25 Mbps and upload speed of 10 Mbps for home use.

• Capability to work from a designated area that minimizes interruptions to safeguard member PHI/HIPAA information.

🏝️ Benefits

• Bonus incentive program based on company and/or individual performance.

• Comprehensive medical, dental, and vision plans.

• 401(k) retirement savings option.

• Paid time off.

• Company and personal holidays.

• Paid parental and caregiver leave.

• Short-term and long-term disability coverage.

• Life insurance.

• Reimbursement for internet expenses for employees residing and working from home in California, Illinois, Montana, or South Dakota.

• Provision of telephone equipment suitable for business needs.

• Remote work arrangement available.

• Occasional travel to Humana offices for training or meetings.