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, and play a pivotal role within Humana's 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 team's 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.

Required Qualifications

• Bachelor's degree with 6+ years of experience driving and creating strategy OR Master's level degree with 4+ years of the same experience.
• 2 years of experience in strategy or management consulting.
• Experience leveraging / interpreting data and analytics to improve strategy and make recommendations.
• Proven skills influencing others and a track record of success leading through ambiguity.
• Proven organization, planning and prioritization skills to collaborate with multiple enterprise departments and stakeholders with the ability to execute within deadlines.
• Experience working independently to manage projects to achieve objectives.
• Intermediate to advanced level of competency with Microsoft Office suite (PowerPoint, Excel).

Preferred Qualifications

Workstyle : Remote, work from home. Travel : Potential for quarterly travel for on-site meetings. Typical work days / hours : Monday Friday, 8 : 00 am 5 : 00 pm EST.

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.

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. Nationwide Remote - This is a remote nationwide position. 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. $138,900 - $191,000 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. Application Deadline : 11-02-2025

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. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https : / / www.humana.com / legal / accessibility-resources?source=Humana_Website.