Overview

The Innovation Portfolio Strategy Advisor reports to a Behavioral Health portfolio director and drives the product lifecycle for assigned products within that portfolio. You will accomplish the product strategy developed by the portfolio director by translating strategy into actual product delivery. The Portfolio Strategy Advisor works across departments to form colleague teams that can support overall delivery of a product, sets prioritization, maintains alignment of effort, and owns delivery.

This position is responsible for advancing Humana's behavioral health network quality and access across both Medicare Advantage (MA) and Medicaid (MCD) lines of business. The role focuses on developing and executing strategies to enhance provider performance, ensure true network access, and drive value-based initiatives that improve care quality and member outcomes.

Key Responsibilities

Network Access Monitoring

• •Establish and maintain real-time insights into general behavioral health (BH) network access and BH specialty areas access including Substance Use Disorder (SUD), Autism Spectrum Disorder (ASD), and Dementia across both MA and MCD.

Provider Performance Measurement

• •Develop, implement, and manage provider scorecards and tiering systems to assess and differentiate provider performance and quality.

Cross-functional Collaboration

• •Partner with MA and MCD network teams, MA network adequacy team, and market leadership teams to use network data and provider performance metrics for continuous improvement of network quality and efficiency.

Value-Based Initiatives

• •Launch and lead Pay-for-Performance (P4P) projects for MA providers.
• •Support and expand ongoing P4P programs within MCD, driving provider engagement and improved member outcomes.

Provider Relationship Management

• •Manage Joint Operating Committees (JOCs) and sustain ongoing relationships with large provider groups.
• •Serve as the primary contact for issue resolution, troubleshooting, and strategic partnership development.

Required Qualifications

• •Bachelor's degree in healthcare, business, or related field
• •7+ years of experience in network strategy, provider relations, or behavioral health management within a managed care setting
• •Experience in pediatric mental health
• •Skilled in developing strategic partnerships and engaging with internal and external stakeholders to support behavioral health initiatives
• •Strong analytical skills with experience in provider performance measurement and network adequacy
• •Proven ability to work with multiple stakeholders, lead cross-functional teams, and implement strategic initiatives
• •Demonstrated ability to articulate ideas effectively in both written and oral forms

Preferred Qualifications

• •Master's degree
• •LCSW or CADC certification
• •Experience with Autism Spectrum Disorder
• •Experience with value-based care and pay-for-performance models
• •In-depth knowledge of behavioral health provider networks for both MA and MCD populations
• •Ability to manage complex provider relationships and drive collaborative outcomes

Compensation and Benefits

• •Pay range: $115,200 - $158,400 per year
• •Eligible for bonus incentive plan based on company and/or individual performance
• •Benefits include medical, dental, and vision coverage, 401(k) retirement savings plan, paid time off, company and personal holidays, paid parental and caregiver leave, short-term and long-term disability, and life insurance

Work Arrangement

• •Remote position with occasional travel to Humana offices for training or meetings
• •Home internet requirements: minimum 25 Mbps download and 10 Mbps upload speed
• •Must work from a dedicated space to protect member PHI and maintain HIPAA compliance
• •Scheduled weekly hours: 40