Senior Network Strategy Professional-- REMOTE/WORK AT HOME (ANYWHERE IN THE US) at Humana

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The Senior Network Strategy Professional oversees various efforts involving complex data analysis and consultation projects/contracts. The Senior Network Optimization Professional work assignments involve moderate to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors to optimize the network by reducing cost of care and improving quality to Medicaid members.


The Senior Network Strategy Professional partners with the Network, Finance and Clinical teams to optimize care rendered to Medicaid members. Makes decisions on moderately complex issues regarding technical approach for project components, and work is performed without direction. Exercises considerable latitude in determining objectives and approaches to assignments.

Job Responsibilities:• Partners with Network, Finance and Quality teams to establish processes to support strategic and optimization initiatives• Provides project management duties to support strategic initiatives• Manages tasks associated with process improvement and tactical execution of network strategy• Represents the Medicaid Operations team in strategic initiative meetings with other departments and/ or Providers• Interfaces with Finance to support contract review process related to strategic initiatives such as conducting a cost benefit analysis for new strategic initiatives• Gathers competitive research on what other MCD plans are doing for network strategic initiatives

Required Qualifications
  • 5+ years of experience in Network, Program Management, Operations, Finance or other relevant/related experience, preferably in a Managed Care environment
  • Project management experience, as well as producing metrics, measurements, and trend reports
  • Must have the ability to travel up to 10%, in order to attend meetings and trainings, as required
  • Strategic thinking and planning capabilities; organized and detail-oriented
  • Proficiency in Microsoft Office applications including Excel.
  • Willingness to manage and prioritize diverse projects
  • Excellent written and verbal communication skills
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications
  • Bachelor's or Master's Degree
  • Experience in Medicaid in the State of Florida
  • Ability to run large scale, highly visible programs with responsibility for multiple project teams.
  • Knowledge of Humana's internal policies, procedures and systems
  • PMP certification or equivalent

Work-At-Home Requirements
• WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.• A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. • Satellite and Wireless Internet service is NOT allowed for this role.• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

COVID Vaccination Policy• For this job, associates are required to be fully COVID vaccinated, including booster or undergo weekly COVID testing and wear a face covering while at work. The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home.

If progressed to offer, you will be required to:• Provide proof of full vaccination, including booster, or commit to testing protocols OR • Provide proof of applicable exemption including any required supporting documentation • Medical, religious, state and remote-only work exemptions are available.

Scheduled Weekly Hours

More Information on Humana
Humana operates in the Healthtech industry. The company is located in Louisville, KY and Chicago, IL. Humana was founded in 1961. It has 40741 total employees. It offers perks and benefits such as Flexible Spending Account (FSA), Disability Insurance, Dental Benefits, Vision Benefits, Health Insurance Benefits and Life Insurance. To see all 99 open jobs at Humana, click here.
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