Humana Hiring for Medicaid Lead, Technology Solutions at Bridgeport, Connecticut Full Time

Description

The Lead, Technology Solutions devises an effective strategy for executing and delivering on IT business initiatives. The Lead, Technology Solutions works on problems of diverse scope and complexity ranging from moderate to substantial.

Responsibilities

The Medicaid Lead, Technology Solutions builds strategic partnerships and manages relationships between IT and the aligned business group(s). The Lead facilitates guidance to business partners on information technology (IT) solutions, stays current on and leverages industry trends, and challenges business and IT to drive for best outcomes by leveraging the best technology solutions. This is achieved by having a clear understanding of business, its strategic direction, and targeted outcomes along with technology trends both internal and external to the organization. The role serves as the Single Point of Contact representing assigned business area(s) to the IT organization and representing Humana IT with internal business partners along with State and Federal regulators. The Lead ensures RFP responses are accurate and reflect the true and competitive capabilities Humana brings to the table, ensures internal SLAs are in place to support contracts, and technology is configured to operate within contractual obligations. The Lead drives solutions at an organizational level to provide maximum value and align to the overarching IT strategy. They measure value to demonstrate and promote the value of IT to their respective areas and the organization as a whole.

Responsibilities

o Builds and maintains relationships with regulators and business leaders to understand the business strategy and needs and to advocate technology solutions to deliver results.

o Serve as the IT Master of Ceremonies for state Readiness Reviews, including arranging with other IT experts to present, as needed, for topics where additional expertise may be needed.

o Stays current on relevant technologies leading efforts to match business needs with best technology solutions.

o Organize and run any one-time or recurring technology-related meetings with state personnel, and/or with the state’s technology partner

o Provide thought leadership for state regulators, Humana market leaders, and occasionally other MCOs when multi-MCO implementations are involved

o Be on point for the technology portion of all state Medicaid compliance audits. These will often tie back to the P&Ps noted here on the previous bullet.

o Collaborate with Market Operations/leadership in problem solving and help with workarounds as required to meet state deadlines that are in significant conflict with Humana IT’s development timelines.

o Serves as the ‘Senior Business Architect’ for Medicaid, with a strong understanding of how the industry’s standard processes are executed in Humana’s environment, from end to end

o Develop and own all state-level Humana IT P&Ps, working with Humana IT compliance, the Privacy Office, and other internal areas as needed

o Participate in Command Centers or other operationally focused meetings as determined by each market

o Participate in Market President’s senior leadership meetings, as appropriate

o Ensure documentation is gathered and distributed to the appropriate market and IT peers for any state led meetings

o Accountable for monitoring contractual SLA performance for State contracts to successfully deliver and avoid potential millions in liquidated damages and maximize revenue

o Responsible for state technology roadmap including delivery of strategic imperatives to position to win and re-win contracts at renewal

o Accountable for collaborating with business and IT peers to collect, maintain and store specifications, documentation, design documents, process flows, etc. relating to the state implementation.

o Leads teams to gathers business requirements and clarify scope during initial discovery by conducting meetings/interviews, and facilitating large group/cross-functional sessions with partners

o Effectively influences key stakeholders, team members, and peers outside of direct control of this role, to deliver optimal solutions in line with the best interests and expectations of the business partner.

o Conducts executive level briefings presentations and solution recommendations

Required Qualifications

• Bachelor’s degree

• Solid understanding of operations, technology, communications and processes

• Possess 10+ years of progressive experience leading continuous improvement efforts, evaluating existing systems and implementing process improvements.

• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Master’s degree

Additional Information

Work-At-Home Requirements

• WAH requirements: Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.

• A minimum standard speed for optimal performance of 25×10 (25mpbs download x 10mpbs upload) is required.

• Satellite and Wireless Internet service is NOT allowed for this role.

• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

#LI – EL1

Scheduled Weekly Hours

40

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.