AVP, In-Home Wellness Strategy – Operations
Humana
full-time
Posted on:
Location Type: Office
Location: Louisville • District of Columbia • Florida • United States
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Salary
💰 $203,400 - $279,800 per year
Job Level
About the role
- Serve as the enterprise leader for in-home risk adjustment and Stars performance in the home.
- Coordinates In-home program will outreach 5 M members, and conduct ~1.5 M preventative in-home visits annually.
- Responsible for bid commitments and corresponding delivery of incremental accurate diagnosis value.
- Ensures 100% compliance with CMS and state regulatory requirements.
- Advance the organization’s reputation as a leader in preventative care and member experience that yields higher retention and growth.
- Accountable to deliver enterprise transformation commitments that ensure a combined strategy and delivery, so members receive accurate diagnosis, Stars care opportunity closure, and follow-up care from in-home visits.
- Ensures flawless execution on care opportunities present during the encounter
- Develop and execute a coordinated enterprise strategy for in-home member engagement, aligning with organizational goals and regulatory requirements.
- Collaborate cross-functionally to integrate home-based wellness initiatives with broader population health management strategies.
- Monitor and analyze emerging industry trends, technologies, and best practices to inform and evolve the in-home wellness approach.
- Oversee the implementation of in-home health and well-being assessments, testing, and diagnostic protocols to accurately evaluate member health status.
- Direct the process for connecting members to appropriate follow-up care, care management referrals, and primary care scheduling based on individual needs.
- Guide the standardization and utilization of health information exchange (HIE) data, lab results, pharmacy claims, and supplemental member information.
- Lead vendor management activities including contract negotiation, credentialing, relationship management, and performance oversight.
- Oversee process documentation, compliance reviews, risk management, and program governance.
- Ensure adherence to all internal and external regulations pertaining to in-home care delivery, data management, and member communications.
Requirements
- Bachelor’s degree
- Minimum of 10 years of progressive experience in healthcare strategy, population health, managed care, or clinical operations, including significant leadership experience.
- Demonstrated expertise in preventative care, home-based health services, and closing care gaps.
- Proven track record of leading cross-functional teams and managing large-scale programs.
- Strong analytical, communication, and executive relationship-building skills.
- Ability to influence and direct senior leaders in order to ensure optimal outcomes
- Experience with vendor management, compliance, and health information technology 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 and many other opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
healthcare strategypopulation healthmanaged careclinical operationspreventative carehome-based health servicesvendor managementcompliancehealth information technologydata management
Soft Skills
leadershipanalytical skillscommunication skillsrelationship-buildinginfluencingcross-functional collaborationprogram managementstrategic planningproblem-solvingexecutive communication