Director, Population Health Strategy

Humana

3d • Remote

About The Position

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.

Requirements

• 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.

Nice To Haves

• 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.

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.

Benefits

• medical
• dental
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Director