Description

Become a part of our caring community
The Population Health Director for the Ohio Medicaid market provides strategic and operational leadership for population health management strategy initiatives. This role is responsible for the design, implementation, and evaluation of strategies that improve health outcomes and reduce disparities among Medicaid members across Ohio. The Director oversees teams dedicated to population health, including community engagement professionals, and collaborates with cross-functional teams, provider partners, community-based organizations, and regulatory agencies to advance Humana's mission and meet Ohio Department of Medicaid (ODM) requirements.

Key Responsibilities:

Oversee the MCO's strategic design, implementation, and evaluation of population health management strategy, including partnering in care management, quality improvement, social determinants of health, community engagement, and member engagement initiatives, based on a deep understanding of scientific population health principles.

Sponsor and champion MCO and system-wide initiatives, cultivating the support necessary to achieve desired operational objectives for each initiative.

Analyze population health data to identify trends, gaps, and opportunities for interventions that improve health outcomes and address health disparities.

Develop and execute community engagement strategies in partnership with internal and external stakeholders, including provider networks, community partners, and state agencies, to maximize program impact.

Liaison with ODM, the OhioRISE Plan, the SPBM, and other ODM-contracted MCOs on population health activities.

Develop and implement operational plans that address market opportunities and challenges, aligning with established population health goals.

Ensure compliance with ODM requirements and Humana's policies related to population health management strategy, community engagement, and quality improvement.

Oversee development and submission of required reports, dashboards, and presentations for internal leadership and external regulatory bodies.

Support value-based care initiatives and alternative payment models by promoting evidence-based practices and continuous quality improvement.

Monitor key performance indicators, manage budgets, and optimize resource allocation to achieve targeted outcomes.

Use your skills to make an impact

Required Qualifications

• Must reside in the state of Ohio
• Master's degree or other advanced degree in nursing, social work, health services research, health policy, information technology, or a related field.
• At least five years of progressively responsible professional experience in population health, service coordination, ambulatory care, community public health, case or care management, or coordinating care across multiple settings and with multiple providers.
• Demonstrated knowledge of Medicaid programs, regulations, and quality measures.
• Experience overseeing and developing professional teams, including community engagement professionals.
• Proven ability to analyze and synthesize population health data to inform strategy and operational improvements.
• Strong leadership, communication, and stakeholder engagement skills.
• Ability to work collaboratively in a matrixed organization and manage multiple priorities.

Additional Information

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

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:

At minimum, 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.

$150,000 - $206,300 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.

About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.

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.
Requisition #: R-414141

bx2d9wfr1