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Job Details

Strategy Advancement Advisor Medicaid Business Development - Remote US

Location
San Antonio, TX, United States

Posted on
Apr 26, 2022

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Description

Humana Healthy Horizons is seeking a Strategy Advancement Advisor (Medicaid Business Development) who will provide data-based strategic direction to identify and address business issues and opportunities. The Strategy Advancement Advisor provides business intelligence and strategic planning support for business segments or the company at large. The Strategy Advancement Advisor works on problems of diverse scope and complexity ranging from moderate to substantial.

Responsibilities

The Strategy Advancement Advisor leads initiatives to analyze complex business problems and issues using data from internal and external sources.


Supports market assessment activities in the government sponsored health care industry (Medicaid, Medicare and Duals).
Leverages expertise and experience to lead the gathering, analyzing, interpreting and presenting of Medicaid and Medicare related clinical and operational performance metrics.
Analyzes clinical, quality, financial, operational, and network data to support integration of effective measures into Medicaid RFP responses.
Conducts in depth competitor analysis to identify areas of opportunity and working collaboratively with business leaders to close gaps based on competitive analysis insights.
Advises executives to develop functional strategies on matters of significance related to improving deficiencies related to performance metrics and outcomes.
Able to work independently and cross-functionally to drive progress on assigned projects.
Gathers and analyzes economic, political, financial and industry data to assess health plan growth opportunities in targeted geographies with particular focus on Medicaid programs (e.g. Temporary Assistance for Needy Families (TANF), State Children's Health Insurance Program (S-CHIP), Aged Blind and Disabled (ABD), Managed Long-term Care program (MLTC), waivers, diversions, etc.) as well as Medicare, Dual SNPs and Healthcare reform opportunities.
Engage with internal SMEs and proposal writers / content developers from various departments to gather data points that convey strong industry leading results, trends and stories.
Assist the RFP writing team by taking data points, and translating them into meaningful stories that address questions in each RFP.
Develop a comprehensive data repository / library that contains data points to be referenced by the proposal writers and internal stakeholders for the inclusion, reference and audit for each individual RFP response.
Retrieve data from external sources such as CMS.gov, HMA, and other external sources.
Works closely and collaboratively with business leaders including P&L owners, Government Affairs, Public Policy, Product, Program Implementations, Network Development, Legal and others in planning, management and support throughout the growth and business development lifecycle.


Required Qualifications


Bachelor's Degree.
3 - 5 years of experience in analyzing and reporting on key health care industry and individual insurance company performance metrics.
2 - 5 years of experience working in a government sponsored health care and/or Medicaid managed care industry.
Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field. Every associate and contractor who work inside a Humana facility or in the field, regardless of vaccination status, must complete a daily health screening questionnaire.
Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
Satellite and Wireless Internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.


Preferred Qualifications


Experience working in a Medicaid Business Development role related to competitor analysis, data analytics, and/or growth opportunity research.
Experience working on Medicaid competitive procurements (RFPs, RFAs, ITNs, etc.).
Experience conducting quality improvement analysis using HEDIS data.


Additional Information


Travel: Up to 10% to various states
Work Days/Hours : Monday - Friday; Eastern Standard Time or Central Standard Time.


Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.

If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.

Scheduled Weekly Hours

40

Company info

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