Sr. Program Delivery Professional, IHWA - Performance

Humana

2d • Hybrid

About The Position

Become a part of our caring community and help us put health first The Senior Program Delivery Professional strategically identifies, develops, and implements programs that influence providers, members or market leadership towards value-based relationships and/or improved quality metrics. The Senior Program Delivery Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Senior Program Delivery Professional for IHWA is responsible for overseeing and advancing key initiatives that drive organic provider capture following an IHWA visit. This position plays a vital role in enhancing organic performance, supporting improved member care outcomes, and ensuring thorough and accurate documentation. Key responsibilities include monitoring program activities, leading efforts to optimize provider participation, and applying expertise in causal analysis and provider office workflows. The role requires collaboration with department leaders to review, interpret, and communicate program results, as well as to inform and influence departmental strategy. The successful candidate demonstrates the ability to make independent decisions on moderately complex to complex technical matters related to project components. The position is characterized by a high degree of autonomy, allowing for significant discretion in determining objectives and methods for assignments.

Requirements

• Minimum three, (3) years of experience in root cause analysis, inner working of provider office and systems, or risk adjustment.
• Proven ability to compare, read, and report on claims data.
• Proven ability to conduct causal analysis and apply findings for program monitoring and improvement.
• Passion for continuous learning and process excellence.
• Excellent collaboration, communication, and stakeholder management abilities.
• Experience with managing and monitoring successful and impactful projects.
• Futuristic and broad thinker with attention to detail and downstream impacts.

Nice To Haves

• Bachelor’s or advanced degree in Healthcare Administration or related field.
• Python, SQL, Databricks, or Power BI experience.
• Risk adjustment background or knowledge.
• Experience in provider office environments and familiarity with provider systems (e.g., Epic, Compass).
• Strong understanding of provider networks, contracting, and service fund.

Responsibilities

• Prioritizing member care outcomes by identifying opportunities to share member data with various provider types to drive complete and accurate documentation by addressing conditions identified during IHWA visits.
• Analyze performance and claims data to monitor and inform strategic decisions.
• Generate innovative ideas and solutions to increase provider engagement and drive organic performance.
• Collaborate with cross-functional teams to advance provider insights into IHWA visit and diagnosis data.
• Leverage experience with provider front end and backend operations, workflows, and systems to inform best practices and effective delivery.
• Strong cause and effect analytical skills to monitor results, identify trends, and recommend actionable advancements.
• Take initiative as a self-starter and proactively seek opportunities to improve program effectiveness.

Benefits

• Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being.
• Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.
• Among our 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