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CenterWell Director, Complex Care Strategy Advancement in Richmond, Virginia

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

The Director, Complex Care Strategy Advancement will play a pivotal role in driving the strategic vision of the organization by identifying, evaluating, and operationalizing high-impact complex care initiatives to drive quality and cost improvement for high-risk senior populations in full risk Medicare arrangements. This individual will be responsible for assessing the value of each opportunity available, validating the feasibility of clinical and operational solutions, and making informed recommendations for program implementation. Leveraging expertise in health trend forecasting and data analysis, the Director will collaborate across functions (particularly Data, Technology, Analytics, Medical Economics, and Finance) to design and optimize strategies that address current and future challenges. By tracking performance metrics and refining interventions, this role ensures sustainable growth and continuous improvement, ultimately advancing the organization’s mission to deliver exceptional care.

Major Duties and Responsibilities

  • Lead strategic opportunity sizing and development by conducting comprehensive assessments to identify opportunities that align with organizational goals, evaluate their potential value, and prioritize initiatives with the highest impact.

  • Drive operational and clinical feasibility validation by collaborating with operational, technology and clinical teams to assess the feasibility of proposed programs, ensuring alignment with organizational capabilities and resources.

  • Lead the evaluation process to determine go/no-go decisions for initiatives, ensuring data-driven and evidence-based justifications for implementation.

  • Develop and oversee robust performance evaluation frameworks to measure program outcomes, track progress and impact against benchmarks and/or targets, and inform continuous optimization strategies.

  • Analyze current and emerging health trends to predict future needs, shaping proactive strategies that position the organization for success.

  • Engage with internal and external stakeholders to gather diverse perspectives and data, ensuring a holistic approach to decision-making and program design.

  • Implement tools and processes to track program impact, assess return on investment, and identify opportunities for refinement and scaling.

Use your skills to make an impact

Required Qualifications

  • Bachelor’s degree

  • A minimum of five years progressively responsible professional experience in health-related strategy and operations positions, preferably in value-based care, particularly managed care or full risk models

  • A minimum of five years of project/people leadership experience

  • Data, product, analytics and impact translator skills to effectively engage cross-functionally in assessing opportunity and feasibility of strategic initiatives

  • Experience in a large, highly matrixed company, with proven ability to influence leaders and key stakeholders in such an environment

  • Excellent qualitative and quantitative analytic skills, with the ability to ask the right question to attack the root causes of problems to be addressed

  • Excellent collaboration capabilities and high EQ; integrator, can connect the dots and understand how to optimize system-level processes

  • Curious, quick learner, innovator but data- and evidence-driven

  • Experience in managing change by leading and energizing others, modeling adaptability, and inspiring strong organizational performance through periods of transformation, ambiguity, and complexity.

  • Excellent relationship-building skills and proven ability to work collaboratively through various departments and functional areas, promoting a culture of proactive teamwork.

  • Excellent oral and written communications skills, including the polish, poise, and executive presence that will ensure effective interaction with executive leadership and multiple types of audiences

  • The ability to clearly explain complex ideas, analytic insights and technologies to non-technical audiences

Preferred Qualifications

  • Master of Business Administration with a minimum of three years experience post Master’s level training, health care actuarial experience, health care technical product and analytics experience

  • Experience working with complex and matrixed value-based health care organizations

  • Experience in a top-tier management consulting firm, venture capital, private equity or similar environment

Knowledge/Skills/Abilities/Competencies Required

  • Strong leadership skills with the ability to gain buy-in and engage in complex teams

  • Exceptional communication and interpersonal skills, with the ability to collaborate effectively with executives, clinicians and data & finance teams and to synthesize, communicate and syndicate effectively with stakeholders at all levels.

  • Strong analytical and problem-solving skills with the ability to develop and implement metrics to measure the effectiveness of strategic programs addressing care transitions, high risk patients, etc.

  • Understanding of clinical operations and ability to guide priorities, process development and implementation.

  • Understanding of quality and value drivers in full risk care delivery, ideally in Medicare/seniors

  • Demonstrated ability to work collaboratively with clinical and operational leaders across a complex health care organization.

  • Knowledge of health care regulations and policies related to care transitions and post-acute care management.

  • Computer skills in word processing, database management, spreadsheets, and report writing.

  • Proficiency in tracking and evaluating process/system outcomes and performing and monitoring rapid cycle process improvement.

  • Excellent project and program management skills

Knowledge/Skills/Abilities/Competencies Required

  • Remote role

  • Occasional travel, 20-30% to various CenterWell and Conviva markets or team on-sites

Work at Home 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

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.

$138,900 - $191,000 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.

Application Deadline: 01-09-2025

About us

About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient’s well-being.

About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.

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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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.

Centerwell, a wholly owned subsidiary of Humana, complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our full accessibility rights information and language options https://www.partnersinprimarycare.com/accessibility-resources

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