Humana - Dover, DE

posted 2 months ago

Full-time - Mid Level
Dover, DE
Insurance Carriers and Related Activities

About the position

The Medicaid Market Development Advisor at Humana plays a crucial role in supporting health plans and specialty companies in the implementation and operations of Medicare, Medicaid, TRICARE, and Employer Group products. This position involves ensuring compliance with regulations, maintaining relationships with regulators, and advising executives on strategic matters. The advisor is expected to exercise independent judgment and decision-making on complex issues while working under minimal supervision.

Responsibilities

  • Provide support to assigned health plans regarding Medicare/Medicaid/TRICARE/Employer Group product implementation and operations.
  • Ensure compliance with corporate performance benchmarks for assigned health plans.
  • Maintain relationships with regulators within the region.
  • Advise executives on functional strategies related to market development.
  • Analyze data to make informed recommendations regarding operations and compliance.

Requirements

  • Bachelor's degree or equivalent.
  • 3 - 5 years of experience with Medicaid/Medicare/Employer Group operations.
  • 3 - 5 years of experience managing large scale projects and cross-functional teams.
  • Proven ability to develop working relationships in a matrixed business environment.
  • Strong analytical skills to interpret data and make recommendations.
  • Experience in procurement negotiation and RFP/RFX processes.
  • Proficiency in MS Office products, especially Excel, Word, and PowerPoint.

Nice-to-haves

  • Master's degree.
  • Experience responding to state and/or federal government solicitations.
  • Experience in developing relationships with key stakeholders to improve market understanding.
  • Certification with Six Sigma and/or Project Management Institute/CPSM.

Benefits

  • Medical, dental, and vision benefits.
  • 401(k) retirement savings plan.
  • Paid time off including company and personal holidays, volunteer time off, and paid parental and caregiver leave.
  • Short-term and long-term disability insurance.
  • Life insurance and additional opportunities for personal wellness.
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