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The Clinical Strategy Team is a multi-disciplinary team focused on using data analysis and clinical acumen to build strategies that improve experiences for our members and providers, drive positive health outcomes, and reduce total cost of care. We are seeking a Clinical Strategy Lead to advance our strategy to ensure our members get the highest quality care. This includes supporting our members going to the highest quality providers, while also understanding root causes of high and low quality care and building strategies to improve quality of care offered. This will involve close partnership with analytical and clinical SMEs to build the strategy and approach, and operational business partners to bring strategies to life. Purpose is to help our members achieve optimal health outcomes and cost-effective care.
The Clinical Strategy Lead will lead high-value, strategic initiatives that directly impact health outcomes and total cost of care of Humana's 5M+ membership. Specifically, this Lead role will drive the strategy to support members going to the highest quality providers. You'll have the opportunity to analyze complex business and clinical issues leveraging healthcare and operational data, while working collaboratively with clinicians, data scientists, actuaries, subject matter experts, and business owners across Humana to drive solutions forward. In this role you will lead quantitative and qualitative analysis to identify data insights and bring the insights to action through cross-organizational collaboration.
Responsibilities include:
Identify and test ways to use Humana capabilities to improve members getting best quality care, which may include ways to influence members choosing or getting referred to the highest quality providers, as well as ways to influence providers to improve quality of care offered.
Lead through influence- partner with multiple areas of the Enterprise to get everyone on the same page and drive high-visibility strategic initiatives forward and deliver results.
Develop and present strategy recommendations to a senior level/ C-suite audience using quantitative and qualitative data plus strong story-telling skills to gain buy-in on direction.
Partner closely with data scientists, actuaries, and clinical associates to frame-up an analytics question, guide analysis, and draw actionable insights to inform strategy.
Synthesize evidence from clinical literature and guidelines, as well as conduct more broad external research (e.g. competitive intelligence), to come up with ideas on approach.
Develop a learning agenda and test plans to ensure we get the learnings from new initiatives to understand their impact and inform future direction.
Utilize strong interpersonal skills, presentation skills, and storytelling skills to get alignment on initiatives among senior leaders, business partners and other stakeholders.
Work cross-functionally with key partners to drive results.
Identify important clinical and experience problems and build the business case to solve them through application of clinical, analytical, and business expertise.
This role will be a great fit if:
You are passionate about improving health outcomes of seniors and ensuring they get high quality care.
You are driven - you're eager to use your strong strategic and analytical acumen to drive impact and create significant measurable value.
You are collaborative - you like partnering with diverse teams across the enterprise to develop strategies and solutions that will work.
You are curious - you enjoy learnings new things, welcome diverse perspectives, and thrive figuring out new paths forward.
Use your skills to make an impact
Role Essentials
Bachelor's degree
7 years or more of healthcare, payor, provider and/or consulting experience
Strategy experience; experience using quantitative and qualitative data to build strategic recommendations and presenting to senior leaders
Self-starter; ability to proactively anticipate needs, create a plan, and problem solve
Experience partnering with analytics teams to analyze data to generate insights
Demonstrated ability to work cross-functionally across multiple teams to drive results
Excellent interpersonal, negotiation and communication skills
Comfortable building presentations and communicating to senior level leadership
Proficient in Excel
Role Desirables
Advanced degree (Masters or Doctorate) in business (MBA), Public Health, Epidemiology, healthcare, Clinical Informatics or related field
Clinical degree (e.g. MD, DO, PharmD, APRN, PA, NP, BSN, RN)
Highly creative and able to think outside the box
Additional Information
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.
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.
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.
$115,200 - $158,400 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
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: 04-14-2026
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at?Humana.com?and at?CenterWell.com.
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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.
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.
