Utilization Management Strategy Lead
Humana
Become a part of our caring community and help us put health first
The UM Strategy team is a multi-disciplinary team focused on creating data-driven strategies to transform our business and the experiences we create for our members, provider partners & associates. We partner closely with our operations partners, working hand-in-hand to translate these strategies into concrete roadmaps that will generate tangible value to all stakeholders. Within Utilization Management, our goal is to enable members to receive the most appropriate type of care as quickly as possible … all while streamlining processes for our provider partners and reducing unnecessary costs from the healthcare system.
Our team employs a rigorous process to set specific business priorities, identifies the greatest sources of value, and leads a multi-disciplinary process to identify discrete opportunities for enhanced clinical outcomes, cost control, quality, and member experience.
This role would be a great fit if …
• You are driven by the opportunity to use your strong strategic and analytical acumen to drive impact and create significant measurable value.
• You are passionate about collaboration and partnering across the enterprise to develop pragmatic, high-value strategies and drive exceptional operational execution of our key objectives.
• You are curious – you enjoy connecting the dots between business metrics and frontline, understanding key root causes for what we see in data, testing hypotheses for what we could improve to drive value, and transforming ideas into action.
The UM Strategy Lead will analyze complex problems and issues related to member care and medical cost. 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 our clinical strategy. Ultimately, they will work with operational owners to translate strategic recommendations to execution plans for implementation.
The UM Strategy Lead will:
Engage in ambiguous problem solving and strategy setting
Use data and insight from experts to identify the greatest opportunities in clinical outcomes, quality, cost, and experience for members/providers/associates
Work directly with cross-functional partners across the enterprise to create the execution model and roadmap to capture prioritized opportunities
Use your skills to make an impact
Role Essentials
Bachelor’s degree in math or business related
Minimum 2 years of experience with a leading management consulting firm
Strong analytical & strategic skillset
Ability to interpret and leverage data and analytics to improve strategy and make recommendations
Experience influencing cross-functional groups of leaders/teams and initiatives
Strong communication skills both verbal and written
Ability to work independently to manage projects to achieve objectives
Intermediate to Advanced level competency with Microsoft Office suite (PowerPoint, Excel)
Intermediate to Advanced level navigating multiple systems/platforms and ability to troubleshoot and resolve general technical difficulties in a remote environment.
Role Desirables
Health care industry experience
Workstyle: Remote work at Home
Location: U.S.
Schedule: M-F 8:00 AM to 5:00 PM Eastern
Travel: None
SSN Alert 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.
Interview Format 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.
Remote Work at Home Guidance 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.
Scheduled Weekly Hours
40Pay 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.
Description of Benefits
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: 09-08-2025
About us
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. 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.