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Behavioral Health Portfolio Strategy Lead

$115.2k - $158.4k

Humana, Inc.

Become a part of our caring community 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. The Innovation Portfolio Strategy Advisor is responsible for advancing Humana's behavioral health network quality and access across both Medicare Advantage (MA) and Medicaid (MCD) LOBs. This position will focus 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. You will be the contact for issue resolution, troubleshooting, and strategic partnership development. Use your skills to make an impact Required Qualifications Bachelor’s degree in healthcare, business, or related field 5 +years’ 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 Excellent interpersonal, negotiation, and communication skills 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 Additional Information Work-At-Home Requirements Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense. A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. Satellite and Wireless Internet service is NOT allowed for this role. A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Scheduled Weekly Hours: 40 Pay Range: $115,200 - $158,400 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. 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. 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 #J-18808-Ljbffr

Vacancy posted 2 days ago
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