Senior Manager, Risk Adjustment Provider Enablement
Homeward
CMS Programs Quality Strategy Lead
Humana
full-time
Posted on:
Origin: • 🇺🇸 United States • California, Illinois, Montana
Visit company websiteSalary
💰 $104,000 - $143,000 per year
Job Level
Senior
About the role
- The CMS Programs Quality Strategy Lead will support Humana through successful participation in CMS/CMMI Multi-Payor and Accountable Care Initiatives.
- Leverages Medicare Advantage framework and provider relationships to assume financial risk for Original Medicare beneficiaries through MSSP.
- Develops and implements Humana MSSP strategy; assists in directing overall Humana MSSP quality strategy.
- Defines MSSP success and strategy using big-picture vision and value-based care experience.
- Partners externally with contracted ACO providers to focus on quality performance.
- Partners cross-functionally with Humana enterprise teams such as clinical, legal, and compliance.
- Fosters internal and external partnerships; reports to Director of Value-Based Strategies - CMS Programs
Requirements
- 6+ years of Medicare or Medicaid experience
- 3+ years of Quality and/or HEDIS experience
- 3+ years project management experience with mid to large scale projects
- Experience with CMMI (Centers for Medicare and Medicaid Innovation) programs
- Experience working with senior leadership
- Solid experience building templates, standard documentation, and disseminating best in class knowledge
- Experience facilitating cross departmental projects
- Excellent oral and written communication skills
- Flexible, dynamic personality who works well in a team environment
