Associate VP, Specialty Core Administration Platforms

Humana • Tampa, FL

1d

About The Position

The Associate Vice President, Specialty Core Administration Platforms, will lead the technology strategy and implementation for Specialty product core systems (including claims processing and payment as well as all-inclusive platforms that wrap in broader functionality such as product, enrollment and so forth) covering Humana’s Dental and Vision plans across both Individual and Group lines of business. This position requires an individual with a thorough understanding of health plan operations and how to support these operations with technology, given that the role will be asked to balance continuing ongoing business with the legacy mainframe systems of today while implementing the innovative cloud and SaaS-based platform of the future. The individual in this role will have frequent interaction with and be accountable to the senior leaders of Humana’s Specialty line of business, where the Dental and Vision plans cover over 11M members and account for nearly $1Bn in annual revenue today with additional groups and growth signed for the future. The Associate Vice President, Specialty Core Administration Platforms partners with the operational leadership of the Specialty line of business to formulate a future technology strategy and then drives the implementation of core technology, primarily focusing on claims adjudication and payment but also extending into adjacent areas of membership and provider data and downstream data strategies. This position requires an individual with a thorough understanding of health plan operations and how to support these operations with technology, including the modernization of legacy technology platforms. The AVP, Specialty Core Admin Platforms will be tasked with continuing to support ongoing business operations on today’s platforms while implementing the systems of the future, including both commercial and in-house developed systems in a combined cloud and SaaS-based ecosystem.

Requirements

• Bachelor’s degree (or equivalent) in Computer Science, Information Technology, Engineering or a comparable technical discipline.
• 10+ years of progressive technology leadership experience, with a demonstrated ability to build high performing teams including attracting, developing, and retaining key technical talent.
• Proven track record (5+ years) of leading teams through complex transformation initiatives in a highly regulated environment, including migration from legacy to new platforms and delivering high-visibility programs within tight timelines.
• Deep understanding of core health plan operations, including claims, enrollment, billing, and provider management processes with an ability to see the bigger picture and build a path to a stronger future.
• Excellent business acumen, communication, and change management skills; able to influence across all levels of the organization and be seen as a key partner to operations.
• Extensive experience in strategic planning, budgeting, allocation and vendor negotiations / management, including outsourcing and offshoring for select activities.

Nice To Haves

• Master’s degree (or equivalent, including equivalent work experience) in Computer Science, Engineering, Business, Healthcare Administration, or related field.
• Proven capability of delivering in a highly matrixed environment, leveraging and holding accountable cross-functional and outsourced teams for DevOps, Architecture, Security and other key functions.
• Familiarity with Humana’s technology platforms and governance frameworks.

Responsibilities

• Develop and execute a strategic technology roadmap that balances legacy platform management to support ongoing business with a rapid transition to a modern core administration platform that will support specialty business and, ideally, other business lines going forward.
• Provide executive level oversight to ensure the reliable operation, optimization and compliance of current technology systems that provide access to care for 11M dental & vision members.
• Lead the rapid implementation, integration and adoption of a new specialty core platform, ensuring a seamless migration of this high-visibility effort on tight timelines while minimizing disruption to current business operations.
• Integrate business ROI with technology solutions, making informed decisions that align with the company's financial goals and deliver the needed solutions within budget.
• Ensure adherence to regulatory requirements, working closely with CMS, state and contractual guidelines to maintain compliance in specialty projects.
• Lead a significant team with a focus on employee satisfaction, professional development, and performance management, including maintaining needed legacy skillsets while developing the new skills needed to transition the team along with the technology.
• Ability to analyze complex technical and operational issues and develop innovative solutions.
• Drive continuous improvement and innovation within the core administration IT department, staying abreast of emerging technologies and industry trends.
• Team-oriented approach with a focus on collaboration and partnership across departments – be seen as the trusted partner for business operations.
• Monitor and report key performance indicators for both legacy and modern platforms, providing actionable insights and executive recommendations.
• Oversee vendor selection, contract negotiations, and ongoing management for outsource and global technology partners on both labor and software.

Benefits

• medical benefits
• 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
• many other opportunities

What This Job Offers

• Job Type: Full-time
• Career Level: Executive
• Number of Employees: 5,001-10,000 employees