Associate Director, Medicare Clinical Coverage Policies

Associate Director, Market / Industry Insights

Become a part of our caring community and help us put health first. The Associate Director, Market / Industry Insights works closely with physicians, nurses, G&A, UMC, vendors, risk, and compliance to ensure all Medicare clinical coverage policies are meeting the needs of the users and that they are compliant. The Associate Director, Market / Industry Insights delivers clinical insight and information to both internal and external customers in order to ensure compliance of the Medicare clinical coverage policies. Meets regularly with customers, brokers, physicians, and other providers to address clinical issues and strategies. Serves as key internal clinical resource for multiple departments, especially clinical management and utilization groups. Leverages clinical experience and deep knowledge of managed care to find the best solutions for all customers. Liaisons with external thought leaders, professional societies, and other community-based organizations focused on improving health status.

Use your skills to make an impact.

Required Qualifications

• Bachelor's Degree
• 6 or more years of technical experience
• 3 or more years of leadership experience with direct reports
• 2 or more years of compliance or policy writing experience
• Strategic thinking and planning capabilities; organized and detail-oriented
• Excellent written and verbal communication skills
• Experience and understanding of Medicare managed care
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

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 required; 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.

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. 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 Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website. Travel : While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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. $104,000 - $143,000 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and / or individual performance.

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.

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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements.