VP, Behavioral Health Strategy
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Job Description
Vice President leading Humana’s Behavioral Health strategy to improve healthcare services across Medicare and Medicaid. Collaborating with internal teams to drive outcomes and efficiency in behavioral health care.
Responsibilities:
- 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
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