Sr. Maternal Health Professional

Humana • Culpeper, VA

7d • Remote

About The Position

Become a part of our caring community and help us put health first The Senior Maternal Health Professional contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Senior Maternal Health Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. Maternal Health Support Professional Lead Role Collaborate with Leadership and Associate Director to design and implement short- and long-term Maternal and Child Health action plans with measurable goals Identify, prioritize, and advance new Maternal and Child Health initiatives to address gaps in care, member needs, and regulatory requirements Establish and maintain partnerships with community organizations, provider networks, and state agencies to enhance service delivery and strengthen access pathways for Humana members Represent Humana Maternity at community events, forums, and collaborative workgroups Be a proxy for the Maternal and Child Health Department in advisory councils, DMAS Maternal workgroups, and other important meetings, such as the Neonatal/Perinatal Collaborations through the VNPC Travel to and participate in provider and community events to promote Humana's Maternal and Child Health programs Together with the AD, the lead will support maternity managers in preparing and submitting regulatory reports Work with leadership to identify access to care challenges, including process improvement, resource building, and collaborations Develop and maintain tracking systems and methodologies for Maternal and Child Health initiatives, including data collection on outcome measures and program effectiveness and compliance Analyze and interpret data to assess impact, inform continuous improvement, and fulfill reporting requirements Be the subject matter expert on maternal child health topics for internal teams, providing guidance on strategy, best practices, and policy interpretation Collaborate with the Associate Director of Maternal and Child Health to lead internal policy and procedure updates Collaborate with internal teams and DMAS to improve maternal and behavioral health initiatives, providing recommendations and submitting detailed reports in accordance with DMAS requests. Advises and guides multiple internal teams, providing advances subject matter expertise and leading the implementation of innovative models for integrates maternal health care. Ensure that all maternal health operations not only meet, but exceed, regulatory, contractual and accreditation requirements, supporting a culture of continuous improvement and compliance across the organization. Monitors, analyzes and interprets emerging maternal health equity trends, providing strategic advice to senior executives and commending transformative opportunities across the enterprise. Leads performance measurement and quality improvement efforts, sponsoring data-driven decision making around network adequacy, utilization, member outcomes, and health equity objectives. Facilitates strategic advisory councils, learning collaboratives, and community forums, establishing Humana as a trusted partner in maternal health innovation. Use your skills to make an impact

Requirements

• Must reside in the Commonwealth of Virginia, preferably the Central Region (Richmond, Tidewater) or NOVA
• Demonstrated experience in large Care Management and Maternal Health implementation.
• Active RN license in the Commonwealth of Virginia, with no disciplinary action OR, LCSW, MSW, BSW, LSW, LPC
• 5 years of experience in maternal health, healthcare transformation, integrated care or related disciplines.
• 5+ years of technical experience using Microsoft Office, Word, Excel, Outlook
• Experience in problem solving and consultation with complex environments.
• Strong influencing and process improvement skills
• Ability to influence department's strategy
• Ability to communicate effectively and deliver presentations to senior leaders.
• Demonstrates decision making on moderately complex to complex issues

Nice To Haves

• Bachelor's degree or Master's degree
• High-level administrative experience with navigating and/or overseeing state's safety net maternal health programs and services through the LGEs, or a similar infrastructure of state-designated local maternal health organizations.
• Knowledge of community resources and behavioral health practices with high-risk populations.
• Process knowledge and designed experience.

Responsibilities

• Collaborate with Leadership and Associate Director to design and implement short- and long-term Maternal and Child Health action plans with measurable goals
• Identify, prioritize, and advance new Maternal and Child Health initiatives to address gaps in care, member needs, and regulatory requirements
• Establish and maintain partnerships with community organizations, provider networks, and state agencies to enhance service delivery and strengthen access pathways for Humana members
• Represent Humana Maternity at community events, forums, and collaborative workgroups
• Be a proxy for the Maternal and Child Health Department in advisory councils, DMAS Maternal workgroups, and other important meetings, such as the Neonatal/Perinatal Collaborations through the VNPC
• Travel to and participate in provider and community events to promote Humana's Maternal and Child Health programs
• Together with the AD, the lead will support maternity managers in preparing and submitting regulatory reports
• Work with leadership to identify access to care challenges, including process improvement, resource building, and collaborations
• Develop and maintain tracking systems and methodologies for Maternal and Child Health initiatives, including data collection on outcome measures and program effectiveness and compliance
• Analyze and interpret data to assess impact, inform continuous improvement, and fulfill reporting requirements
• Be the subject matter expert on maternal child health topics for internal teams, providing guidance on strategy, best practices, and policy interpretation
• Collaborate with the Associate Director of Maternal and Child Health to lead internal policy and procedure updates
• Collaborate with internal teams and DMAS to improve maternal and behavioral health initiatives, providing recommendations and submitting detailed reports in accordance with DMAS requests.
• Advises and guides multiple internal teams, providing advances subject matter expertise and leading the implementation of innovative models for integrates maternal health care.
• Ensure that all maternal health operations not only meet, but exceed, regulatory, contractual and accreditation requirements, supporting a culture of continuous improvement and compliance across the organization.
• Monitors, analyzes and interprets emerging maternal health equity trends, providing strategic advice to senior executives and commending transformative opportunities across the enterprise.
• Leads performance measurement and quality improvement efforts, sponsoring data-driven decision making around network adequacy, utilization, member outcomes, and health equity objectives.
• Facilitates strategic advisory councils, learning collaboratives, and community forums, establishing Humana as a trusted partner in maternal health innovation.

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.

What This Job Offers

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