Senior Market Development Professional - Kentucky Medicaid

Humana•Louisville, KY

10d•Hybrid

About The Position

The Senior Market Development Professional supports Kentucky Medicaid product implementation, operations, contract compliance, and regulatory deliverables. This role leads operational oversight support, including meeting preparation, action tracking, and execution of strategic initiatives. The professional 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. This role also drives process improvement to ensure health plan efficiencies and best practice implementation.

Requirements

Bachelor's degree
5 or more years of experience in a 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
Must reside in KY or surrounding states with the ability to work in the office 2 days a week at minimum.
Self-provided internet service must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested. Satellite, cellular and microwave connection can be used only if approved by leadership.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

Master's Degree
Medicaid experience
PMP certification
Six Sigma
Proficient with Microsoft office products

Responsibilities

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.
Document, maintain, and improve core Market Operations processes; update procedures as needed and support implementation of new projects.
Interpret regulatory/operational data and partner with Data & Reporting to produce insights that inform market strategy and leadership decisions.
Coordinate meetings, manage deliverables, and track implementation of cost-saving initiatives.
Track market oversight activities and drive closure of compliance actions and process improvements.
Develop agendas, coordinate KMOO sessions, and manage post-meeting action items focused on compliance, trends, and consumer experience.
Support Consumer Experience Professional 2 by coordinating assignments and implementing process improvements from call listening sessions.
Coordinate communications and operational changes with vendor management professionals to ensure vendor compliance with Health plan and vendor contract.
Ensures implementation of program updates and member/provider communications coordinating through vendor management professionals.
Ensure alignment between regulatory reports and the KDMS Operations Insights Dashboard for accuracy and transparency.
Maintain the Plan Resource Manual (contacts and processes) to support market execution.