Become a part of our caring community and help us put health first
 

The Associate Vice President, In-Home Wellness Strategy and Execution will serve as the strategic leader responsible for developing, executing, and overseeing the enterprise-wide preventative care strategy delivered in members’ homes. This leader will ensure a holistic understanding of member health status through accurate diagnosis, facilitate closing care gaps during in-home encounters, and coordinate seamless connection to appropriate follow-up care. This position will oversee a high performing, highly skilled team of 6 direct reports (including 4 Directors, 1 Principal, and 1 Associate Director) which all manage teams as well. The total org is 45 associates in total, relying on 6 vendors and >10k clinicians.

Key Responsibilities:

• Serve as the enterprise leader for in-home risk adjustment and Stars performance in the home.
• Coordinates In-home program will outreach 5 M members, and conduct ~1.5 M preventative in-home visits annually.
• Responsible for bid commitments and corresponding delivery of incremental accurate diagnosis value.
• Ensures 100% compliance with CMS and state regulatory requirements.
• Advance the organization’s reputation as a leader in preventative care and member experience that yields higher retention and growth.
• Accountable to deliver our enterprise transformation commitments that ensure a combined strategy and delivery, so members receive accurate diagnosis, Stars care opportunity closure, and follow-up care from in-home visits.
• Ensures flawless execution on care opportunities present during the encounter
• Serves as a key leader/support for the SVP Risk Adjustment and other Insurance Operations leadership as well as the Market MRA Directors, and Centerwell leadership. 
• DRI for annual in-home visit volume & value commitments made in direct support of the annual Medicare Advantage bid process
• Primary enterprise relationship owner for key external partnerships and steward for over annual vendor spend.

• Strategic Leadership:
  • Develop and execute a coordinated enterprise strategy for in-home member engagement, aligning with organizational goals and regulatory requirements.
  • Collaborate cross-functionally to integrate home-based wellness initiatives with broader population health management strategies.
  • Monitor and analyze emerging industry trends, technologies, and best practices to inform and evolve the in-home wellness approach.
  • Partner with marketing and corporate initiatives to reduce member outreach and provide an improved member experience while delivering on visit volume goals.

• Program Management & Execution:
  • Oversee the implementation of in-home health and well-being assessments, testing, and diagnostic protocols to accurately evaluate member health status.
  • Ensure the effective closure of identified care gaps during in-home visits, including but not limited to preventive screenings, chronic condition management, and health education.
  • Direct the process for connecting members to appropriate follow-up care, care management referrals, and primary care scheduling based on individual needs.

• Data-Driven Insights:
  • Guide the standardization and utilization of health information exchange (HIE) data, lab results, pharmacy claims, and supplemental member information.
  • Foster enterprise-wide reporting, audit, and data management practices to ensure accurate documentation, coding, and outcomes measurement.
  • Champion best practices for leveraging analytics to identify opportunities for improvement and demonstrate program impact.

• Vendor & Provider Relations:
  • Lead vendor management activities including contract negotiation, credentialing, relationship management, and performance oversight.
  • Establish and monitor service level agreements (SLAs) and compliance with relevant standards (e.g., HITRUST).
  • Cultivate provider engagement to support scheduling of PCP visits, buy-in, and coordinated post-visit follow-up.

• Governance & Compliance:
  • Oversee process documentation, compliance reviews, risk management, and program governance.
  • Ensure adherence to all internal and external regulations pertaining to in-home care delivery, data management, and member communications.

Use your skills to make an impact
 

Required Qualifications

• Bachelor’s degree
• Minimum of 10 years of progressive experience in healthcare strategy, population health, managed care, or clinical operations, including significant leadership experience.
• Demonstrated expertise in preventative care, home-based health services, and closing care gaps.
• Proven track record of leading cross-functional teams and managing large-scale programs.
• Strong analytical, communication, and executive relationship-building skills.
• Ability to influence and direct senior leaders in order to insure optimal outcomes
• Experience with vendor management, compliance, and health information technology preferred

Preferred Qualifications

• Master’s degree
• STARS and Risk Adjustment experience

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.

 

$203,400 - $279,800 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.

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.

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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.