Humana Trend Director in Boston, Massachusetts
The Director, Strategy Advancement (or Trend Director) leads initiatives to analyze complex business problems and issues using data from internal and external sources. Brings expertise or identifies subject matter experts in support of multi-functional efforts to identify, interpret, and produce recommendations and plans based on company and external data analysis. Ensures that policies and procedures align with corporate vision. Selects, develops, and evaluates personnel ensuring efficient operation of the function. Decisions are typically related to the implementation of new/updated programs or large-scale projects for the function and supporting technical/operational procedures and processes, and implements strategic plans, drives goals and objectives, and improves performance. Provides input into function’s strategy.
The focus of the role is on developing Humana at Home's pipeline of initiatives to reduce avoidable medical cost and achieve measurable ‘Trend’ savings. This includes:
Using data analysis, external market / competitive best practices, and academic / scientific publications, and other sources to identify opportunities to reduce medical costs ("Trend opportunities") among Humana's Medicare population -- including but not limited to reducing preventable hospitalizations, non-emergent ER visits, and readmissions
Developing financial analysis to determine the economic value of initiatives; developing a budget and request for funding as needed
Developing and maintaining a robust Trend pipeline
Designing pilot programs to test new Trend opportunities, including working developing creative solutions to IT and operational constraints
Making persuasive presentations to senior executives about the progress of Trend initiatives
Reviewing academic literature about best practices in Care Management and Care Delivery and making connections with leaders in the field
Demonstrating an understanding and interest in statistical methods of quantifying the value of clinical activities, including Randomized Controlled Trials, propensity matching, predictive algorithms
Partnering with functions inside Humana to design and launch clinical initiatives
Building relationships with Risk Providers and applying their feedback to Trend initiatives
Soliciting feedback from member-facing associates and channels on new Trend opportunities and value of existing Trend opportunities
Using creative methods to develop a 'culture of Trend' within Humana at Home
Define KPIs to measure the impact of Trend initiatives
Creative problem solving to determine how to deploy innovative clinical models in highly regulated and Compliance-focused environments like Humana's Special Needs Plans
Leading a team of associates to perform the above functions
Ability to use data analytics and draw insights that enable change
Curiosity to think about how to improve health and medical trends
Direct experience leading teams to drive successful strategic initiatives in the health care field
Experience leading complex quantitative analysis, including financial analysis
Enterprise mindset -- ability to drive the objectives of both the Home Solutions division and the company at large
Comprehensive knowledge of all Microsoft Office applications, including Powerpoint, Word, and Excel
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Masters Degree, preferably in a Clinical or Business field
Proficiency in analyzing and interpreting financial trends
Experience working with senior executives, including making presentations to executive audiences
Scheduled Weekly Hours
Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.
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