Bachelor's degree in healthcare or business7+ years network strategy / provider relationsBehavioral health managementProvider performance measurementCross-functional team leadershipMedicare Advantage & Medicaid knowledgeStakeholder & partner engagementStrong analytical skillsValue-based care / Pay-for-PerformanceProvider relationship management (JOCs)Master's degreeBH specialty networks (SUD, ASD, Dementia)
Job Description
Humana is seeking an Innovation Portfolio Strategy Advisor to drive product lifecycle and strategy execution for behavioral health services across Medicare Advantage and Medicaid lines of business. The role focuses on network access monitoring, provider performance measurement, value-based initiatives, and cross-functional collaboration to enhance behavioral health network quality and member outcomes.
Overview
The Innovation Portfolio Strategy Advisor reports to a Behavioral Health portfolio director and drives the product lifecycle for assigned products within that portfolio. This role translates strategy into actual product delivery, works across departments to form colleague teams, 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 focus is 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
•Skilled in developing strategic partnerships and engaging with internal and external stakeholders to support behavioral health initiatives
•Proven ability to work with multiple stakeholders, lead cross-functional teams, and implement strategic initiatives
•Strong analytical skills with experience in provider performance measurement and network adequacy
•Demonstrated ability to articulate ideas effectively in both written and oral forms
Preferred Qualifications
•Master's degree
•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
Work Environment
•This is a remote position with occasional travel to Humana's offices for training or meetings.
•Home internet requirements: minimum download speed of 25 Mbps and upload speed of 10 Mbps; wireless, wired cable, or DSL connection suggested.
•Work must be performed from a dedicated space lacking ongoing interruptions to protect member PHI and HIPAA information.
•Employees in California, Illinois, Montana, or South Dakota will receive a bi-weekly payment for internet expenses.
Compensation and Benefits
•Pay range: $115,200 - $158,400 per year, based on location, skills, experience, and education.
•Eligible for a 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.
About Humana
Humana Inc. is a leading U.S. healthcare company. Through Humana insurance services and CenterWell healthcare services, Humana makes it easier for the millions of people it serves to achieve their best health, delivering care and service to people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large.
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