Behavioral Health Network Strategy Lead

Humana Inc; United States; Remote; USD 115,000 - 158,000; Full time

Job summary

Humana Inc. is seeking a senior leader to drive network strategy and provider relationships across behavioral health programs, including SUD, ASD, and Dementia, in a remote-capable role.

You will develop scorecards, monitor access, and launch P4P initiatives, collaborating with MA and MCD teams to improve member outcomes and network quality.

The position requires 8+ years of experience, a Bachelor's degree, and strong analytical and communication skills.

Qualifications

• Bachelor's Degree in a related field.
• 8+ years' experience in network strategy, provider relations, or behavioral health management within a managed care setting.
• Skilled at developing strategic partnerships and engaging with internal and external stakeholders to support behavioral health initiatives.
• Proven ability to lead cross-functional teams and implement strategic initiatives.
• Strong analytical skills, with experience in provider performance measurement and network adequacy.
• Excellent written and oral communication skills.

Responsibilities

• Network Access Monitoring: Establish and maintain real-time insights into general behavioral health (BH) network access and BH specialty areas access - including Substance Use Disorder (SUD), Autism Spectrum Disorder (ASD), and Dementia - across both MA and MCD.
• Provider Performance Measurement: Develop, implement, and manage provider scorecards and tiering systems to assess and differentiate provider performance and quality.
• Cross-functional Collaboration: Partner with MA and MCD network teams, MA network adequacy team, and market leadership teams to use network data and provider performance metrics for continuous improvement of network quality and efficiency.
• Value-Based Initiatives: Launch and lead Pay-for-Performance (P4P) projects for MA providers.
• Support and expand ongoing P4P programs within MCD, driving provider engagement and improved member outcomes.
• Provider Relationship Management: Manage Joint Operating Committees (JOCs) and sustain ongoing relationships with large provider groups.
• You will be the contact for issue resolution, troubleshooting, and strategic partnership development.
• Use your skills to make an impact

Skills

Bachelor's Degree

Network strategy

Provider relations

Behavioral health management

Cross-functional leadership

Education

Bachelor's Degree

Job description

Humana Inc. is seeking a senior leader to drive network strategy and provider relationships across behavioral health programs, including SUD, ASD, and Dementia, in a remote-capable role.

You will develop scorecards, monitor access, and launch P4P initiatives, collaborating with MA and MCD teams to improve member outcomes and network quality.

The position requires 8+ years of experience, a Bachelor's degree, and strong analytical and communication skills.