Senior Market Development Professional - Kentucky Medicaid

Responsibilities The Senior Market Development Professional supports Kentucky Medicaid product implementation, operations, contract compliance, and regulatory deliverables. You will lead operational oversight support, including meeting preparation, action tracking, and execution of strategic initiatives. You will use regulatory and operational data to drive insights, align reporting, and ensure follow-through across all associated work streams to ensure health plan compliance. Drive process improvement to ensure health plan efficiencies and best practice implementation. Market oversight and monitoring: Market oversight and monitoring of required contractual processes. Initiate escalation/tickets with business areas/workstreams for analysis and correction. Provide regulatory, contractual and procedural guidance. Operational process improvement: Document, maintain, and improve core Market Operations processes; update procedures as needed and support implementation of new projects. Additionally, you will strengthen market execution across: Data Analysis and Reporting: Interpret regulatory/operational data and partner with Data & Reporting to produce insights that inform market strategy and leadership decisions. Cost of Care Realignment: Coordinate meetings, manage deliverables, and track implementation of cost‑saving initiatives. Market Oversight and Compliance: Track market oversight activities and drive closure of compliance actions and process improvements. Kentucky Medicaid Operations Oversight Meeting Management: Develop agendas, coordinate KMOO sessions, and manage post‑meeting action items focused on compliance, trends, and consumer experience. Consumer Experience Initiatives: Support Consumer Experience Professional 2 by coordinating assignments and implementing process improvements from call listening sessions. Vendor Support: Coordinate communications and operational changes with vendor management professionals to ensure vendor compliance with health plan and vendor contract. Ensure implementation of program updates and member/provider communications through vendor management professionals. Regulatory Reporting Alignment: Ensure alignment between regulatory reports and the KDMS Operations Insights Dashboard for accuracy and transparency. Plan Resource Manual: Maintain the Plan Resource Manual (contacts and processes) to support market execution. Required Qualifications Bachelor's degree 5 or more years of experience in an insurance or health care setting 2 or more year's experience interpreting regulations and contracts Demonstrated experience implementing and measuring outcomes for complex health‑related initiatives/pilots Strong relationship‑management and stakeholder‑influence skills Process improvement mindset; ability to document, standardize, and enhance operational workflows Commitment to improving consumer experience Preferred Qualifications Master's Degree Medicaid experience PMP certification Six Sigma Proficient with Microsoft office products Additional Information Must reside in KY or surrounding states with the ability to work in the office 2 days a week at minimum. Benefits Health benefits effective day 1 Paid time off, holidays, volunteer time and jury duty pay Recognition pay 401(k) retirement savings plan with employer match Tuition assistance Scholarships for eligible dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development 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 Accessibility Resources . #J-18808-Ljbffr Humana Inc