Senior Market Development Professional - Kentucky Medicaid

Become a part of our caring community The Senior Market Development Professional supports Kentucky Medicaid product implementation, operations, contract compliance, and regulatory deliverables. You will lead operational oversight support, including meeting preparation, action tracking, and execution of strategic initiatives.

You will use regulatory and operational data to drive insights, align reporting, and ensure follow-through across all associated work streams to ensure health plan compliance. Drive process improvement to ensure health plan efficiencies and best practice implementation.

Critical position requirements: Market oversight and monitoring: Market oversight and monitoring of required contractual processes. Initiate escalation/tickets with business areas/workstreams for analysis and correction. Provide regulatory, contractual and procedural guidance.

Operational process improvement: Document, maintain, and improve core Market Operations processes; update procedures as needed and support implementation of new projects. Additionally, you will strengthen market execution across: Data Analysis and Reporting: Interpret regulatory/operational data and partner with Data & Reporting to produce insights that inform market strategy and leadership decisions.

Cost of Care Realignment: Coordinate meetings, manage deliverables, and track implementation of cost-saving initiatives. Market Oversight and Compliance: Track market oversight activities and drive closure of compliance actions and process improvements.

Kentucky Medicaid Operations Oversight Meeting Management: Develop agendas, coordinate KMOO sessions, and manage post-meeting action items focused on compliance, trends, and consumer experience. Consumer Experience Initiatives: Support Consumer Experience Professional 2 by coordinating assignments and implementing process improvements from call listening sessions.

Vendor Support: Coordinate communications and operational changes with vendor management professionals to ensure vendor compliance with Health plan and vendor contract. Ensures implementation of program updates and member/provider communications coordinating through vendor management professionals.

Regulatory Reporting Alignment: Ensure alignment between regulatory reports and the KDMS Operations Insights Dashboard for accuracy and transparency. Plan Resource Manual: Maintain the Plan Resource Manual (contacts and processes) to support market execution.

Use your skills to make an impact Required Qualifications Bachelor's degree 5 or more years of experience in a insurance or health care setting 2 or more year's experience interpreting regulations and contracts Demonstrated experience implementing and measuring outcomes for complex health-related initiatives/pilots Strong relationship-management and stakeholder-influence skills Process improvement mindset; ability to document, standardize, and enhance operational workflows Commitment to improving consumer experience Preferred Qualifications Master's Degree Medicaid experience PMP certification Six Sigma Proficient with Microsoft office products Additional Information Must reside in KY or surrounding states with the ability to work in the office 2 days a week at minimum.

WAH Internet Statement To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.

Satellite, cellular and microwave connection can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.

Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Benefits Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including: Health benefits effective day 1 Paid time off, holidays, volunteer time and jury duty pay Recognition pay 401(k) retirement savings plan with employer match Tuition assistance Scholarships for eligible dependents Parental and caregiver leave Employee charity matching program Network Resource Groups (NRGs) Career development opportunities HireVue As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability.

HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. SSN Alert Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file.

When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website. 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. $78,400 - $107,800 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About Us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com. 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.