Program Delivery Lead
New
H
HumanaBehavioral health
United StatesFull-TimeLead
Salary$115,200 - $158,400 per year
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Job Details
- Experience
- 8 +years’ experience in network strategy, provider relations, or behavioral health management within a managed care setting
- Required Skills
- Cross-functional Team Leadership
Requirements
- Bachelor’s degree.
- At least 8 years’ experience in network strategy, provider relations, or behavioral health management within a managed care setting.
- Skill in developing strategic partnerships and engaging internal and external stakeholders to support behavioral health initiatives.
- Ability to work with multiple stakeholders, lead cross-functional teams, and implement strategic initiatives.
- Strong analytical skills, including experience in provider performance measurement and network adequacy.
- Ability to articulate ideas effectively in written and oral forms.
- Master’s degree is desirable.
- Experience with value-based care and pay-for-performance models is desirable.
- In-depth knowledge of behavioral health provider networks for MA and MCD populations is desirable.
- Ability to manage complex provider relationships and drive collaborative outcomes is desirable.
Responsibilities
- Establish and maintain real-time insights into general behavioral health network access and access to specialty areas, including SUD, ASD, and dementia, across MA and MCD.
- Develop, implement, and manage provider scorecards and tiering systems to assess provider performance and quality.
- Partner with MA and MCD network teams, the MA network adequacy team, and market leadership to improve network quality and efficiency using network data and provider performance metrics.
- Launch and lead Pay-for-Performance projects for MA providers.
- Support and expand ongoing Pay-for-Performance programs within MCD.
- Manage Joint Operating Committees and ongoing relationships with large provider groups.
- Serve as the contact for issue resolution, troubleshooting, and strategic partnership development.
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