Utilization Management Strategy Principal

Utilization Management (UM) Strategy Principal

Become a part of our caring community and help us put health first. Join Humana as a Utilization Management (UM) Strategy Principal. Play a pivotal role within Humanas Utilization Management Strategy team, a collaborative group dedicated to leveraging data and insights to improve clinical outcomes, member experiences, and operational efficiency across our organization. The UM Strategy Principal analyzes complex challenges in utilization management, working directly with operations partners and executive leaders to develop and implement actionable, data-driven strategies that streamline care delivery and reduce unnecessary costs for both members and provider partners. This position leads cross-functional teams in identifying high-impact opportunities, setting clear business priorities, and translating strategic recommendations into detailed execution roadmaps. The ideal candidate will demonstrate strong analytical and strategic thinking skills, thrive in ambiguous environments, and be passionate about driving measurable value through enterprise-wide collaboration. This role offers the opportunity to directly influence the quality and effectiveness of our utilization management programs, while contributing to the teams broader mission of transforming healthcare delivery at Humana. The UM Strategy Principal will analyze complex problems and issues related to utilization management using data and insights from internal and external sources. They will bring expertise or identify subject matter experts in support of multi-functional efforts to identify, interpret, and produce recommendations and plans. This role is highly collaborative and will work closely with associates and executive leaders from across the enterprise to solicit input, guide data-backed problem solving, and make recommendations to advance utilization management strategy. Ultimately, they will work with operational owners to translate strategic recommendations to execution plans for implementation.

The UM Strategy Principal will :

• Engage in problem solving and medium to long term strategy setting.
• Use data and insight from experts to identify the greatest opportunities in clinical outcomes, quality, cost, and experience for members / providers / associates in utilization management programs.
• Lead cross-functional teams to define discrete opportunities that are both impactful and achievable.
• Work directly with cross-functional partners across the enterprise to create the execution model and roadmap to capture prioritized opportunities.

Required Qualifications :

Preferred Qualifications :

Additional Information :

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.

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.