Clinical Business Lead

Overview

Become a part of our caring community and help us put health first. As Regional Clinical Business Lead, you serve as a key member of the regional clinical team responsible for supporting data-driven clinical strategy, performance monitoring, and continuous quality improvement within the Medicare Advantage program to support improving the health of members. The role requires close collaboration with regional leadership and cross-functional teams to ensure alignment with initiatives to drive improved member health outcomes. You will work directly with the Regional Vice President of Health Services (RVP) and Health Services Director (HSD) to advance regional clinical strategy, enable connections with physicians and providers, support innovation initiatives, implement clinical programs, vet new vendor programs, and ensure performance management.

Primary Responsibilities

Data Analytics to Support Clinical Strategy, Performance Reporting, and Monitoring

• Analyze chronic condition performance so regional clinical leadership can bring insights to provider groups to drive awareness, education and action plans.
• Evaluate the effectiveness of clinical program initiatives through analysis of the downstream impact of such initiatives on facility and provider performance in value-based programs.
• Identify opportunities for new clinical program initiatives by assessing cost and utilization drivers, inclusive of a chronic condition focus.
• Prepare data and evaluate performance to support RVP and HSD in governance and delegation oversight committee and interact with the corporate delegation compliance and auditing teams.

Project management and Activity tracking

Vendor / Pilot Program Evaluation and Monitoring

Other duties as assigned

Use your skills to make an impact

Required Qualifications

Preferred Qualifications

Work-At-Home Requirements

To ensure Home or Hybrid Home / Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home / Office associates must meet the following criteria :

Additional Information

Standard Business Hours : Monday-Friday; Pacific, Mountain, or Central time zone

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.

$86,300 - $118,700 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 : 10-14-2025

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.

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