Principal, Clinical Strategy and Program Development

Become a part of our caring community The Principal, Care Integration Clinical Strategy and Program Development is a critical leadership role responsible for the success of the portfolio of Care Integration programs within the Complex Care vertical of centralized programming to serve CenterWell Senior Primary Care’s (and Conviva Senior Primary Care’s) highest need and complexity patients with care and case management services. The Principal is response for the strategic direction, execution and ongoing management of the platforms, products, and analytics – along with their associated workflows and operations – underpinning our High Risk Patient Management (HRPM) program and Transitions of Care Management (TCM) and condition management program, both of which are designed to improve quality and reduce costs for high-risk senior populations in full-risk Medicare arrangements. The Principal will be the key cross-functional owner of the strategic planning, development, and effectiveness of these tools. Working in a matrixed environment, the Principal is a director-level, individual contributor role, with responsibility for platform, product and analytics tooling, collaborating with IT, Product (Athena, SalesForce), Analytics (DataHub), and Medical Economics teams to deliver offerings supporting the 500+ FTE care teams driving program delivery and patient outcomes. The ideal candidate will possess a strong strategic, analytics and platform tool background (particularly with a lens toward VBC provider delivery offerings), a deep understanding of value-based care principles, and a proven ability to understand an overall vision, while engaging with detail-oriented specifications and considerations, and motivate cross-functional teams. This leader will provide ongoing program support through active communication and consultation with the operational, strategic and clinical leaders driving program delivery. Portfolio scope High Risk Patient Management Program–Care and case management interdisciplinary offering for top 5% highest need patients Transitions of Care Management,LongitudinalCare Management,andCondition ManagementProgram – Post acute care managementinterdisciplinaryofferingfor patients following an acute IP/Obsutilizationevent.Ongoing Care Management forhigh complexity patients to addressclinical,behavioral,and social needs.Conditionmanagement supporting patients with unmanaged diabetes and hypertension. New programming as advanceCare Integration strategic plan Tooling scope Care team platforms – Athena,SalesForceHealthcloud, owned by the IT and Product teams AI tooling – Various tools, currently built into Athena andSalesForceHealthCloud, owned by the AI IT team Analytics – Power BI dashboarding and reporting, owned by theDataHubteam Predictiveanalytics– Readmission predictionscores,owned by Data Science team Newtoolingasneeded toadvance Care Integration strategic plan Core Responsibilities Develop,socialize, andimplementCare Integration Team toolingstrategy inpartnership and collaboration withoperational leaders, clinical leaders, IT, population health, and analytics. Product-related activities (SF, Athena, AI-tools): Support development of product strategy Develop and prioritize the intake Design the product intake feature specifications Test the features & provide feedback to product team Collect feedback from frontline staff & Managers for product enhancements Train Education team & frontline staff on product features and hold regular office hours (in coordination with Education team) Coordinate with Change Committee Manage products:SalesForce, Athena, Genesys, AI (e.g., Ambient AI) Manage HRP score logic & coordinate with clinical and data science Coordinate with shared services for improvement / new initiatives e.g., Genesys, Call Center (e.g., call center scheduling patients in 7D), Center Ops (e.g., HIMS,Trueshore) Manage the IT Budget (in coordination with Complex Care VP) Design & manage implementation of metric / dashboard enhancements Prioritize analytics initiatives Develop metric definitions Design dashboard UI Co-develop sprint-plans with analytics partners Coordinate development of metrics with analytics team Conduct metric QA Act as point of contact for analytics and product-related questions Required Qualifications Bachelor’s degree 5+years progressively responsible professional experience in health-relatedproduct, IT, analytics,preferably in value-based care, particularly managedcareor full risk models 5+years ofcross-functionaltranslation tooling experience (e.g., sitting between clinical leadership team and hands-on-keys product development team) Experience in developing performance dashboards–specificallydefiningmetricdefinitions,collaborating withanalyticsandtechteams toimplementdashboards,andperformingmetricquality checks-anddefiningproductfeaturespecifications The ability to clearly explain complex ideas, analyticinsightsand technologies to non-technical audiences Experience in a large, highly matrixed company, with proven ability to influence leaders and key stakeholders in such an environment, within and outside of direct reporting lines Excellent qualitative and quantitative analytic skills, with the ability to ask the right questions toidentifythe root causes of problems to be addressed Excellent collaboration capabilities and high EQ; integrator, can connect the dots and understand how tooptimizesystem-level processes Excellent oral and written communications skills, including the polish, poise, and executiveand authenticpresence that will ensure effective interaction withleadership and front line / manager users of tools Preferred Qualifications Master of Business Administration with threeyears experiencepostMaster’slevel training Data, product,analyticsand impact translator skills to effectively engage cross-functionally in assessing opportunity and feasibility of strategic initiatives Experience working with design teams tooptimizeuser experience for platformsand tools Characteristics of the qualified candidate: A highly credible leader with deep understanding and empathy for thecare team andpatient pain points in day-to-dayvalue-based operations Excellence communication skills, including follow-through communication, executive presentations, and the ability to negotiate with horizontal and upward/downward vertical networks Comfortable managing influence in the context of multiple operations, development, and deployment initiatives in a matrixed environment Additional Information Remote role,20% travel to variousCenterWell& Conviva markets,on-sites 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: 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. $138,900 - $191,000 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: 06-10-2026 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. Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options #J-18808-Ljbffr Humana Inc