VP, Foundational Capabilities

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

The VP, Foundational Capabilities will lead strategic initiatives to transform and advance Stars back to industry leading. This role is responsible for leveraging emerging technologies, innovative provider and member engagement strategies, and effective external partner collaboration to drive exceptional performance across all current and future proposed Stars measures. This high visibility role will work to ensure the organization remains agile, forward-thinking, and aligned with industry best practices and regulatory requirements.

• Continuously monitor and analyze industry trends, CMS updates, competitor activity, and market dynamics that impact the Medicare Stars landscape.

• Develop and communicate insights to inform organizational strategy and ensure proactive responses to changes in the regulatory and competitive environment.

• Accountable for ensuring top executives are well informed and have the right information on competitive intelligence to make decisions, highlighting risks, opportunities, and recommended actions.

• Oversee strategy and integration of digital tools, automation, and artificial intelligence to enhance operational efficiency and support data-driven decision making.

• Evaluate, select, and implement innovative technology solutions that streamline Stars data capture, analytics and operational impact.

• Partner with IT, Digital and Experience teams to ensure emerging opportunities are integrated and feedback loop complete.

• Develop engagement models to enhance provider connectivity working closely with Interoperability and Provider Connection teams.

• Design emerging educational programs and resources that equip providers and members with actionable data, best practices, and compliance guidance.

• Establish feedback mechanisms to gather input and continuously improve partnership effectiveness.

• Serve as the primary liaison between internal teams, external partners, vendors, and regulatory agencies for Stars initiatives.

• Lead cross-functional work groups to align priorities, share knowledge, and ensure accountability in delivering on Stars objectives.

• Manage long term strategic planning with strategic partners to ensure value realization and support long-term program success.

Scale: 4 directors

• Bachelor’s Degree in Business Administration, Health Administration or a related field

• Progressive experience in the health solutions industry, with emphasis on leading and managing teams

• Prior Medicare/Medicaid experience

• Knowledge of HEDIS/Stars and CMS quality measures

• Prior managed care experience

• Proficiency in analyzing and interpreting healthcare data and trends

• Strong attention to detail and focus on process and quality

• Excellent communication skills

• Ability to operate under tight deadlines

• Comprehensive knowledge of all Microsoft Office applications, including Word, Excel and Power Point

• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

• Master’s degree in business administration, Health Administration or a related field

• 5 or more years of Stars experience

• Proven organizational and prioritization skills and ability to collaborate with multiple departments

• PMP certification a plus

• Six Sigma Certification also a plus

• Experience with AI and emerging Digital/Technology solutions

Travel:
While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

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Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and Center Well 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…