at Humana in Dover, Delaware, United States
Become a part of our caring community and help us put health first The Clinical Strategy team is a multi-disciplinary team focused on creating data-driven strategies to transform our business and the experiences we create for our members, provider partners & associates. We partner closely with our operations counterparts, working hand-in-hand to translate these strategies into concrete roadmaps that will generate tangible value for all stakeholders.
Within the Utilization Management (UM) Strategy team, our goal is to enable members to receive effective, appropriate care in a timely manner … all while streamlining processes for our provider partners and reducing unnecessary costs from the healthcare system. The Utilization Management Strategy Analyst role works closely with internal and external stakeholders, such as clinical operations, markets, provider contracting, and analytics to investigate new opportunity areas, design and execute initiatives, inform UM policies and ultimately ensuring efficient healthcare delivery.
This role would be a great fit if …
You are passionate about Utilization Management – you're motivated by driving positive health outcomes for members and reducing waste in the healthcare system You are driven – you're eager to use your strong strategic and analytical acumen to drive impact and create significant measurable value You are collaborative- you like partnering across the enterprise to develop pragmatic, high-value strategies and drive exceptional execution of our key objectives You are curious – you enjoy connecting the dots between business metrics and frontline, understanding key root causes for what we see in data, testing hypotheses for what we could improve to drive value, and transforming ideas into action As the Utilization Management Strategy team, our mission sits at the intersection of members, provider partners and associates. We seek to (1) ensure members receive safe, high-quality and cost-effective care in a timely manner, (2) create best-in-class experiences for members and providers, (3) achieve these outcomes while driving operating efficiency.
As a Utilization Management Strategy Analyst, you will play a pivotal role in optimizing healthcare resource utilization, ensuring cost-effective care delivery, and improving patient outcomes. You'll collaborate with cross-functional teams, analyze data, and develop strategies to enhance the efficiency of healthcare services within our organization.
The UM Strategy Analyst will:
+ Inform the design and development of Utilization Management (UM) policies and procedures
+ Partner with Analytics SMEs to monitor utilization patterns, identify trends, and explore solutions
+ Collaborate with stakeholders across the enterprise to enhance care coordination, reduce unnecessary services, and improve patient experiences.
+ Contribute to strategic projects related to network management, cost containment, and population health.
+ Stay informed about industry trends, evidence-based practices, and emerging technologies
Use your skills to make an impact Required Qualifications + Bachelor's degree in health care administration, public health, statistics, or economics with 2+ years of experience in creating strategy and/or operations
Preferred Qualifications: + Strong analytical, problem-solving, and critical thinking skills, with attention to detail and accuracy
+ Ability to interpret and leverage data to improve strategy, drive insights and make recommendations
+ Strong written & verbal communication, presentation and interpersonal skills
+ Experience working with multi-disciplinary teams (e.g., actuaries, statisticians, operational leaders and clinicians)
+ Ability to work both independently and collaboratively in a fast-paced and dynamic environment
+ Competency with Microsoft Office suite (PowerPoint, Excel)
Additional Information Interview format : As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.
SSN Statement: Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from with instructions on how to add the information into your official application on Humana's secure website.
WAH Statement: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Scheduled Weekly Hours 40
Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$84,600 – $116,300 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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.
About us Humana Inc. ( NYSE : HUM ) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.
Equal Opportunity Employer It is the policy of ?Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of ?Humana?to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall appl
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