[Hiring] Innovation Portfolio Strategy Advisor @Humana

Role Description

The Innovation Portfolio Strategy Advisor reports to a Behavioral Health portfolio director and drives the product lifecycle for assigned products within that portfolio. You will accomplish the product strategy developed by the portfolio director by translating strategy into actual product delivery. The Portfolio Strategy Advisor works across departments to form colleague teams that can support overall delivery of a product, sets prioritization, maintains alignment of effort, and owns delivery.

The Innovation Portfolio Strategy Advisor is responsible for advancing Humana's behavioral health network quality and access across both Medicare Advantage (MA) and Medicaid (MCD) LOBs. This position will focus on developing and executing strategies to enhance provider performance, ensure true network access, and drive value-based initiatives that improve care quality and member outcomes.

Key Responsibilities

• Network Access Monitoring: Establish and maintain real-time insights into general behavioral health (BH) network access and BH specialty areas access—including Substance Use Disorder (SUD), Autism Spectrum Disorder (ASD), and Dementia—across both MA and MCD.
• Provider Performance Measurement: Develop, implement, and manage provider scorecards and tiering systems to assess and differentiate provider performance and quality.
• Cross-functional Collaboration: Partner with MA and MCD network teams, MA network adequacy team, and market leadership teams to use network data and provider performance metrics for continuous improvement of network quality and efficiency.
• Value-Based Initiatives: Launch and lead Pay-for-Performance (P4P) projects for MA providers. Support and expand ongoing P4P programs within MCD, driving provider engagement and improved member outcomes.
• Provider Relationship Management: Manage Joint Operating Committees (JOCs) and sustain ongoing relationships with large provider groups. You will be the contact for issue resolution, troubleshooting, and strategic partnership development.

Qualifications

• Bachelor’s degree in healthcare, business, or related field
• 5+ years’ experience in network strategy, provider relations, or behavioral health management within a managed care setting
• Skilled in developing strategic partnerships and engaging with internal and external stakeholders to support behavioral health initiatives
• Proven ability to work with multiple stakeholders, lead cross-functional teams and implement strategic initiatives
• Strong analytical skills, with experience in provider performance measurement and network adequacy
• Excellent interpersonal, negotiation, and communication skills

Requirements

• Master’s degree (Preferred)
• Experience with value-based care and pay-for-performance models (Preferred)
• In-depth knowledge of behavioral health provider networks for both MA and MCD populations (Preferred)
• Ability to manage complex provider relationships and drive collaborative outcomes (Preferred)

Benefits

• 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
• Many other opportunities

Company Description

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.