Humana Healthy Horizons is seeking a Market Development Advisor who will work side-by-side with the Medicaid COO and team to ensure that the health plan is meeting or exceeding corporate Medicaid performance benchmarks and contractual obligations. Helps advise executives in developing functional strategies on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.
The Market Advisor develops strategy for project planning and facilitates coordination and communication between owners and other teams responsible for execution and production.
- Collaborates with cross functional teams across the Enterprise, including Member and Provider Call Center, Claims, Clinical, Provider Relations, Network Operations, etc.
- Operates as a problem solver, highly self-motivated, organized, detail-oriented, and will exhibit a high level of initiative.
- Serves as an essential member of the Market Operations team leading multiple projects of varying levels of complexity.
- Collaborates with executive leaders on risk mitigation objectives and operational enhancements.
- Communicates responsibilities, assignments, and deliverables to teams, and at key points throughout projects.
- Coordinates and leads meetings with stakeholders to ensure accountability and timely delivery of Market Operations campaigns and project outcomes.
- Drives planning and implementation of operational process improvement activities for various functional areas.
- Develops plans of action to prevent delays in projects and/or the department’s workflow.
- Bachelor’s Degree.
- Minimum two (2) years with health plan operations experience, preferably Louisiana Medicaid Manage Care.
- Minimum three to five (3-5) years managing large scale, strategic projects and cross functional teams.
- Must reside in the state of Louisiana.
- Process and continuous improvement experience.
- Proven ability to develop working relationships within a highly matrixed business environment.
- Strong interpersonal skills resulting in exceptional rapport with people.
- Ability to analyze data and make informed recommendations.
- Proficiency in Microsoft applications including PowerPoint and Access.
- Advanced proficiency in Excel specifically creating and using pivot tables for reports of large data sets.
- Experience using Visio and/or MS Project to develop and manage project plans.
- Ability to manage multiple competing priorities in a fast paced environment.
- Excellent verbal and written communication skills.
- This role is part of Humana’s Driver safety program and therefore requires an individual to have a valid state driver’s license and proof of personal vehicle liability insurance with at least 100,000/300,000/100,000 limits.
- Must have a room in your home designated as a home office; away from high traffic areas where confidential information may be secured.
- Must have the ability to provide a high-speed DSL or cable modem for a home office (Satellite and Wireless Internet service is NOT allowed for this role). A minimum standard speed for optimal performance of 10×1 (10mbs download x 1mbs upload) is required.
- For this job, associates are required to be fully COVID vaccinated 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. We are a healthcare company committed to putting health and safety first for our members, patients, associates, and the communities we serve.
- If progressed to offer, you will be required to: Provide proof of full vaccination OR Commit to weekly testing, following all CDC protocols, OR Provide documentation for a medical or religious exemption consideration. This policy will not supersede state or local laws. Requests for these exemptions should be submitted at least 2 weeks prior to your scheduled first day of work.
- Master’s Degree
- Six Sigma and / or Project Management Institute certification.
- Experience working in Louisiana Medicaid Managed Care.
- Work Style: Remote currently but Hybrid Office in the future in one of two office locations. The office locations are in Baton Rouge and Metairie, Louisiana. The Hybrid Office schedule is typically 3 – 4 days per week and the remaining work days of the week will be remote. Office schedule frequency will be determined by leadership.
- Travel: up to 50%.
As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive correspondence inviting you to participate in a pre-recorded Voice Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
Scheduled Weekly Hours