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The AVP, Medicaid Business Integration is responsible for leading the execution of cross-functional operating model initiatives across the Medicaid segment, particularly where close coordination is needed between centralized and market-based teams. This role leads integration, decision-making, and delivery for work that spans multiple functions. The AVP ensures initiatives are clearly defined, decisions are made within established timeframes, and execution continues through implementation and sustained adoption. The AVP is accountable for translating strategic priorities into operating models that deliver measurable impact on cost, quality, experience (provider, member & associate), and operational performance.

Key Responsibilities

Lead Execution of Cross-Functional Operating Model Initiatives

• Lead execution of select, high-impact initiatives requiring coordination across centralized and market teams, including:
  • Centralization of services
  • Process standardization
  • Workflow redesign across functions
• Translate strategic intent into clear operating models, roles, workflows, and timelines
• Foster alignment and collaboration across:
  • Centralized functions
  • Market leadership
• Focus on initiatives where:
  • Ownership spans multiple functions
  • Decisions require cross-functional alignment
  • Execution depends on engagement and integration across stakeholders

Drive Cross-Functional Integration and Decisions

• Lead forums and processes to resolve complex, cross-functional decisions
• Define and drive clarity on:
  • Standardization vs. market flexibility
  • Resource allocation
  • Sequencing and prioritization
• Establish and enforce decision timelines and accountability

Ensure Delivery and Accountability

• Support initiative owners in achieving milestones, deliverables, and outcomes, and ensure accountability for results
• Identify risks, remove barriers, and drive issue resolution
• Proactively communicate and escalate critical issues and decisions, providing clear recommendations to stakeholders
• Ensure initiatives move from design through implementation to sustained adoption, with ongoing focus on member and provider experience

Define and Implement Operating Model Changes

• Collaborate with functional and market leaders to define and implement changes in work processes
• Drive thoughtful consolidation, standardization, and workflow redesign
• Ensure alignment of process, technology, organizational structure, and associate engagement

Establish Execution Governance

• Establish and lead an execution governance model that includes:
  • Cross-functional decision forums
  • Initiative reviews and consistent execution cadence
  • Transparent executive-level reporting
• Maintain a unified view of all work, including dependencies, risks, and progress

Deliver Measurable Outcomes

• Ensure initiatives deliver measurable impact, including:
  • Medical cost trend improvement
  • Administrative cost efficiency
  • Quality performance (e.g., STARS, HEDIS)
  • Enhanced provider and member experience
• Track value realization, incorporate feedback, and adjust priorities to maximize outcomes

Use your skills to make an impact

Required Qualifications

• Bachelor's degree; Master's preferred
• 5+ years of experience in Medicaid
• 5+ years leading teams
• Demonstrated success leading enterprise cross-functional execution or operating model initiatives
• Experience working across clinical, operational, and corporate functions
• Proven ability to drive results in a matrixed organization without direct authority
• Strong financial and operational acumen, including understanding of cost of care and administrative cost drivers

Critical Capabilities

• Execution Leadership: Proven ability to deliver complex work from concept through implementation
• Influence Without Authority: Ability to align and challenge senior leaders to drive decisions
• Operating Model Thinking: Understands how structure, process, and technology connect
• Structured Problem Solving: Brings clarity and direction in ambiguous environments
• Accountability Mindset: Drives ownership and follows through to outcomes

Reporting Structure

• Reports to: SVP, Medicaid Operations and will have 2-3 direct reports
• Works closely with: Medicaid Segment President/CEO, Functional SVPs, Enterprise partners

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
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 atHumana.comand atCenterWell.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.