VP, Foundational Capabilities

Humana

2d•Remote

About The Position

Become a part of our caring community and help us put health first The VP, Foundational Capabilities will lead strategic initiatives to transform and advance Stars back to industry leading. This role is responsible for leveraging emerging technologies, innovative provider and member engagement strategies, and effective external partner collaboration to drive exceptional performance across all current and future proposed Stars measures. This high visibility role will work to ensure the organization remains agile, forward-thinking, and aligned with industry best practices and regulatory requirements. Competitive Intelligence Continuously monitor and analyze industry trends, CMS updates, competitor activity, and market dynamics that impact the Medicare Stars landscape. Develop and communicate insights to inform organizational strategy and ensure proactive responses to changes in the regulatory and competitive environment. Accountable for ensuring top executives are well informed and have the right information on competitive intelligence to make decisions, highlighting risks, opportunities, and recommended actions. Stars Technology Advancement Oversee strategy and integration of digital tools, automation, and artificial intelligence to enhance operational efficiency and support data-driven decision making. Evaluate, select, and implement innovative technology solutions that streamline Stars data capture, analytics and operational impact. Partner with IT, Digital and Experience teams to ensure emerging opportunities are integrated and feedback loop complete. Provider and Member Engagement Develop engagement models to enhance provider connectivity working closely with Interoperability and Provider Connection teams. Design emerging educational programs and resources that equip providers and members with actionable data, best practices, and compliance guidance. Establish feedback mechanisms to gather input and continuously improve partnership effectiveness. Partner Coordination Serve as the primary liaison between internal teams, external partners, vendors, and regulatory agencies for Stars initiatives. Lead cross-functional workgroups to align priorities, share knowledge, and ensure accountability in delivering on Stars objectives. Manage long term strategic planning with strategic partners to ensure value realization and support long-term program success. Scale 4 directors Use your skills to make an impact

Requirements

Bachelor’s Degree in Business Administration, Health Administration or a related field
Progressive experience in the health solutions industry, with emphasis on leading and managing teams
Prior Medicare/Medicaid experience
Knowledge of HEDIS/Stars and CMS quality measures
Prior managed care experience
Proficiency in analyzing and interpreting healthcare data and trends
Strong attention to detail and focus on process and quality
Excellent communication skills
Ability to operate under tight deadlines
Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and PowerPoint
Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Nice To Haves

Master’s degree in business administration, Health Administration or a related field
5 or more years of Stars experience
Proven organizational and prioritization skills and ability to collaborate with multiple departments
PMP certification a plus
Six Sigma Certification also a plus
Experience with AI and emerging Digital/Technology solutions

Responsibilities

Continuously monitor and analyze industry trends, CMS updates, competitor activity, and market dynamics that impact the Medicare Stars landscape.
Develop and communicate insights to inform organizational strategy and ensure proactive responses to changes in the regulatory and competitive environment.
Accountable for ensuring top executives are well informed and have the right information on competitive intelligence to make decisions, highlighting risks, opportunities, and recommended actions.
Oversee strategy and integration of digital tools, automation, and artificial intelligence to enhance operational efficiency and support data-driven decision making.
Evaluate, select, and implement innovative technology solutions that streamline Stars data capture, analytics and operational impact.
Partner with IT, Digital and Experience teams to ensure emerging opportunities are integrated and feedback loop complete.
Develop engagement models to enhance provider connectivity working closely with Interoperability and Provider Connection teams.
Design emerging educational programs and resources that equip providers and members with actionable data, best practices, and compliance guidance.
Establish feedback mechanisms to gather input and continuously improve partnership effectiveness.
Serve as the primary liaison between internal teams, external partners, vendors, and regulatory agencies for Stars initiatives.
Lead cross-functional workgroups to align priorities, share knowledge, and ensure accountability in delivering on Stars objectives.
Manage long term strategic planning with strategic partners to ensure value realization and support long-term program success.