VP, Medicare Market Operations and Business Performance

Humana

3d • Remote

About The Position

The Vice President, Medicare Market Operations & Business Performance is an enterprise leader responsible for driving market-level operating performance, financial outcomes, and strategic execution across the organization’s Medicare Advantage Regions. This role leads a data-driven performance management model across Medicare markets, translating complex operational, financial, clinical, and consumer data into actionable strategies that improve growth, profitability, quality outcomes, and member experience. The VP partners closely with regional market leadership, actuarial, finance, network, clinical operations, Stars, and enterprise analytics to identify performance gaps, prioritize operational interventions, and accelerate results.

Requirements

• Bachelor’s degree required; MBA, MHA, MPH, or related graduate degree strongly preferred
• 15+ years of leadership experience in healthcare or health insurance
• Deep experience in Medicare Advantage operations and market performance management
• Demonstrated success managing large-scale operational and financial performance in complex, matrixed organizations
• Experience driving enterprise performance improvement initiatives using advanced analytics
• Strong familiarity with Medicare regulatory, reimbursement, and quality frameworks
• Enterprise strategic thinking
• Advanced financial and analytical acumen
• Executive communication and stakeholder influence
• Ability to translate data into actionable business strategy
• Proven ability to lead transformation across highly matrixed organizations

Responsibilities

• Enterprise Medicare Market Performance Leadership: Lead enterprise oversight of Medicare market operational and financial performance across multiple geographies. Drive accountability for membership growth, medical cost performance, quality outcomes, and operating margin.
• Data-Driven Performance Management: Translate large-scale operational, financial, and clinical data into strategic insights and market interventions. Identify emerging trends in medical cost, utilization, risk adjustment, and member engagement and deploy targeted performance improvement strategies.
• Financial & Operational Execution: Partner with finance and actuarial leaders to manage Medical Loss Ratio, administrative cost efficiency and margin improvement.
• Cross-Enterprise Collaboration: Align operational priorities across the enterprise to ensure consistent delivery of Medicare strategy at the market level.
• Market Intelligence & Strategic Insight: Monitor competitive market dynamics, regulatory developments, and demographic trends affecting Medicare markets.
• Leadership: Build and lead a high-performing team responsible for Medicare market analytics, operational strategy, and performance governance. Foster a culture centered on accountability, transparency, and data-driven decision making.

What This Job Offers

• Job Type: Full-time
• Career Level: Executive