Senior VP, Clinical Product & Medicare Strategy

Humana Inc; Nashville (TN); Remote; USD 203,000 - 280,000; Full time

Job summary

CenterWell Home Health is seeking an AVP, Clinical Product & Strategy to set the strategic direction for clinical programs serving Medicare Advantage and Traditional Medicare populations across 37 states, impacting more than 400,000 patients.

The leader will translate enterprise priorities into scalable home-based care models, oversee a ~20-person team, and partner with Home, Pharmacy, Primary Care and Humana to build business cases, launch pilots, and scale programs that support nationally

Qualifications

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Responsibilities

• Own MA value creation strategy: Develop the roadmap for clinical programs that improve HH and MA Stars performance, affordability, risk adjustment, and member outcomes.
• Oversee clinical program execution: Provide day-to-day oversight of strategic clinical programs, including performance management, issue resolution, and cross-functional coordination.
• Improve Quality and Stars performance: Lead gap closure and quality improvement efforts for CWHH populations, partnering with clinical, analytics, population health, and MA teams.
• Drive appropriate Home Health utilization: Expand appropriate use of Home Health services and demonstrate the associated network savings, member impact, and operational requirements.
• Reduce avoidable medical costs: Scale interventions that reduce hospitalizations, readmissions, emergency department utilization, and other avoidable costs.
• Advance member engagement and longitudinal care: Build programs that improve outreach, participation, adherence, and ongoing care management beyond a single Home Health episode.
• Expand high-risk member services: Identify and develop services for high-risk members outside the traditional Home Health episode, including new home-based care models and pilots.
• Improve ecosystem integration: Strengthen clinical integration across CWHH, PCO, Rx, and Humana through shared workflows, data, care pathways, and operating routines.

Skills

Strategic leadership

Medicare Advantage

Value-based care

Cross-functional leadership

Financial acumen

Care management

Education

Bachelor’s degree in healthcare, business, or related field; Master’s degree preferred

Job description

CenterWell Home Health is seeking an AVP, Clinical Product & Strategy to set the strategic direction for clinical programs serving Medicare Advantage and Traditional Medicare populations across 37 states, impacting more than 400,000 patients.

The leader will translate enterprise priorities into scalable home-based care models, oversee a ~20-person team, and partner with Home, Pharmacy, Primary Care and Humana to build business cases, launch pilots, and scale programs that support nationally