Market Development Advisor

Humana, Inc.

$94K — $130K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • U.S. citizenship required for Department of Defense contract
  • Must achieve interim approval for government security clearance
  • 5 years of leadership and management experience
  • Experience in fiscal stewardship and cost management
  • Network management and development expertise
  • Experience in managed care
  • Proven ability to coordinate diverse functions

Responsibilities

  • Oversee daily TRICARE activities within designated service areas
  • Provide consultative services to healthcare personnel to enhance integrated care
  • Direct TRICARE service delivery and network operations including support activities
  • Respond to TRICARE inquiries and resolve concerns from beneficiaries and providers
  • Develop and implement Alternative Payment Methodologies aligned with Value-Based Care models
  • Collaborate with community agencies to support military family health and resilience
  • Travel and work irregular hours as needed for oversight activities

Benefits

  • Medical, dental, and vision benefits
  • 401(k) retirement savings plan
  • Paid time off including personal and volunteer days
  • Paid parental and caregiver leave
  • Short-term and long-term disability insurance
  • Life insurance and additional wellness opportunities
Full Job Description
As a Market Development Advisor you will report to a Market Director, and work on site at our Fort Drum office. This role will have full responsibility and accountability for the daily management of the TRICARE contract within your assigned geography.
  • You will oversee day-to-day TRICARE activities within a territory that includes designated Prime Service Areas (PSAs), Non-Prime Service Areas (NPSAs), MTFs, Coast Guard clinics, and National Guard and Reserve Units.
  • You will provide consultative services to DHN and MTF personnel to create and sustain a local high-quality integrated healthcare system congruent with the Military Health System (MHS) Quadruple Aim.
  • You will direct daily TRICARE service delivery and network operations to include customer support and outreach activities, network adequacy, access to care standards, provider relationships, provider education, and provider management within the defined geographic area.
  • You will have oversight of response to TRICARE inquiries, resolution of complaints, issues and concerns from beneficiaries, providers, and Government personnel.
  • You will participate in the development and deployment of Alternative Payment Methodologies and Demonstration Pilots aligned to Value Base Care models.
  • You will partner with community agencies to connect military families with local programs that target and enhance military health and resilience.
  • This position may require travel and work during uncommon duty hours to conduct oversight and outreach activities.

Use your skills to make an impact

Required Qualifications
  • Our Department of Defense Contract requires U.S. citizenship for this position
  • Successfully receive interim approval for government security clearance (NBIS - National Background Investigation Services)
  • HGB is not authorized to do work in Puerto Rico per our government contract. We are not able to hire candidates that are currently living in Puerto Rico.
  • 5 years of leadership and management experience
  • Experience with fiscal stewardship or responsibility for managing cost trends
  • Network management and development experience
  • Managed care experience
  • Experience coordinating the activities of diverse functions


Preferred Qualifications
  • Bachelor's degree
  • Experience in the Military Health System
  • Experience with TRICARE contracts


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.

$94,900 - $130,500 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.

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