VP, Behavioral Health Strategy
Humana
full-time
Posted on:
Location Type: Remote
Location: United States
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Job Level
About the role
- Develop and execute a comprehensive enterprise-wide behavioral health strategy that sustainably improves clinical outcomes, access, affordability and member experience across insurance segments (Medicare and Medicaid).
- Establish and track key success metrics including quality, access and financial metrics, such as medical trend reduction and administrative costs.
- Lead a dedicated team of behavioral health experts and engage cross functional teams to ensure collaboration and accountability.
- Collaborate with partners across the enterprise to develop, articulate, implement, evaluate, and refine a set of strategic initiatives.
- Optimize network and benefit design, care management, and referral pathways for timely, high-quality behavioral health care.
- Identify impactable drivers of poor outcomes for members with behavioral health needs.
- Implement cost-effective strategies to drive medical trend reductions.
- Evolve enterprise-wide approach to behavioral health outcome measurement.
- Support efforts to enhance operational efficiency in utilization management, claims payment, and provider contracting.
- Explore and implement partnerships to expand Humana’s impact on behavioral health outcomes.
- Drive behavioral health innovation, including virtual care and value-based payment models.
- Lead opportunity analysis and define target state for Humana’s behavioral health strategy.
- Implement operating model solutions, including build/buy/vendor assessments as needed.
Requirements
- Preferred MD or DO, board certified in psychiatry, internal medicine or family practice.
- Demonstrated experience in clinical leadership and strategy development within managed care or health plan environments.
- Proven ability to drive results through influence across a matrixed organization.
- Expertise in healthcare operations, technology solutions and process optimization.
- Deep knowledge of Medicare and Medicaid regulatory requirements and behavioral health policy.
- Track record of identifying and rectifying broken processes and systems with a passion for transformative change with proven ability to drive enterprise-wide transformation.
- Strategic and data-driven mindset with strong analytical, operational, and change management skills with proficiency in data analysis tools.
- Excellent and straightforward communication, collaboration and problem-solving abilities coupled with the ability to tell the story and manage conflict at all levels of the organization.
- Excellent organizational and project management skills; able to track and manage complex enterprise processes and initiatives from start to finish.
- Working knowledge of financial evaluation and M&A processes with experience with integrating acquisitions preferred.
- Experience managing external consulting partners from strategy development to execution.
Benefits
- Health insurance
- Flexible work arrangements
- Professional development opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical leadershipstrategy developmenthealthcare operationsprocess optimizationdata analysisfinancial evaluationM&A processesbehavioral health policyvalue-based payment modelsutilization management
Soft Skills
influenceanalytical skillsoperational skillschange managementcommunicationcollaborationproblem-solvingorganizational skillsproject managementtransformative change
Certifications
MDDOboard certified in psychiatryboard certified in internal medicineboard certified in family practice