Bring your financial and analytical expertise to a role that supports the success of Humana's Oklahoma Medicaid programs and provider network. As the Directed Payment Programs Manager, you'll use financial and healthcare data to help ensure accurate payments, strengthen program performance, and support regulatory compliance. Reporting to the Director, Financial Planning & Analysis, you'll collaborate across teams to solve complex problems and turn data into insights that inform business decisions.
Directed Payment Program Administration- Manage key activities supporting Oklahoma Medicaid Directed Payment Programs.
- Monitor program activity and compliance with OHCA, CMS, and contractual requirements.
- Validate provider payment calculations and methodologies.
- Coordinate quarterly payments, reporting, and financial reconciliations.
Analytics & Data Management- Analyze data and support payment validation, reporting, and financial oversight.
- Analyze claims, encounters, provider, and membership data to identify trends and data issues.
- Develop recurring and ad hoc reports for leadership and external stakeholders.
- Investigate and resolve discrepancies across systems and data sources.
Financial Analysis & Reconciliation- Perform reconciliations for directed payments, provider incentives, and Medicaid funding.
- Support monthly and quarterly financial close activities.
- Analyze budget-to-actual variances and communicate findings to leadership.
- Assess financial impacts of payment adjustments, operational changes, and regulatory updates.
Stakeholder Collaboration- Serve as a key contact for providers, state agencies, and internal stakeholders.
- Lead cross-functional coordination across Finance, Network, Operations, Actuarial, Compliance, and Technology.
- Translate complex financial and analytical findings into clear business insights.
- Build effective relationships with providers, OHCA, and internal partners.
Compliance & Audit Support- Ensure payment and reporting activities meet regulatory, contractual, and corporate requirements.
- Support internal and external audits through analysis and documentation.
- Maintain process documentation and standard operating procedures.
Use your skills to make an impact Required Qualifications- Bachelor's degree in finance, accounting, economics, healthcare administration, information systems, data analytics, or related field.
- Minimum 5 years of progressive experience in finance, accounting, analytics, healthcare operations, or related business functions.
- Advanced Excel skills, including financial modeling and data analysis.
- Experience performing reconciliations, variance analysis, and financial reporting.
Preferred Qualifications- Master's degree (MBA, MHA, MS Analytics, Accounting, Finance, or related field).
- Healthcare or Medicaid managed care experience.
- Experience with Medicaid Directed Payment Programs, provider incentives, value-based payment programs, or supplemental payment programs.
- Knowledge of healthcare claims, encounters, membership, and provider data.
- Experience using Power BI, Tableau, SAS, Snowflake, Oracle, or other enterprise analytics platforms.
- CPA, CMA, or other relevant professional certification preferred.
Additional Information- Work Style: Hybrid Office - 2-3 days per week in Humana's Oklahoma City office.
- Typical Schedule: Monday - Friday, 8:00 AM - 5:00 PM CST
- Travel: up to 10%.
Scheduled Weekly Hours40
Pay RangeThe 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.
$93,600 - $128,700 per year
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of BenefitsHumana, 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.
