Clinical Strategy and Program Development Lead

Humana

. Identify and evaluate opportunities to improve clinical performance across priority populations and specialties through data analysis, measurement gap assessment, and development of performance frameworks and quality measures .

Posted 10/5/2026full-timeRemote • United StatesSenior💰 $115,200 - $158,400 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in developing clinical performance frameworks, quality measures, and strategic roadmaps to enhance healthcare outcomes. Proficient in data analysis and stakeholder collaboration to drive improvement initiatives aligned with enterprise objectives.

Highest-signal resume keywords

Healthcare StrategyClinical Performance ImprovementData AnalysisCross-Functional LeadershipExecutive Communication

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Quantitative Data AnalysisQualitative Data AnalysisBusiness Case DevelopmentStrategic Roadmap DevelopmentPerformance Measurement MethodologiesHealthcare Claims Data AnalysisClinical Coding Systems KnowledgeQuality Measurement MethodologiesPerformance AnalyticsPopulation Health Management

Soft Skills

Influencing Without AuthorityProblem SolvingProactive Opportunity IdentificationNavigating AmbiguityStorytelling Skills

Tools & Technologies

Microsoft ExcelMicrosoft PowerPoint

Certifications & Qualifications

Clinical Degree or LicensureAdvanced Degree (MBA, MPH, etc.)

Industry Keywords

Value-Based CareQuality ImprovementMedicare AdvantageHealthcare ConsultingProvider Performance

About the role

Key responsibilities & impact

Identify and evaluate opportunities to improve clinical performance across priority populations and specialties through data analysis, measurement gap assessment, and development of performance frameworks and quality measures
Conduct strategic assessments of clinical performance and measurement gaps to identify improvement opportunities and advance enterprise priorities
Conduct specialty landscape analyses and identify gaps in performance, measurement, and enterprise capabilities to inform future investment decisions
Develop business cases, strategic recommendations, and adoption approaches for new clinical initiatives
Develop and maintain strategic roadmaps that prioritize future clinical performance opportunities and align investments with enterprise objectives
Own and maintain a pipeline of future clinical performance opportunities aligned to enterprise priorities
Develop clinical performance frameworks, quality measures, and measurement strategies to evaluate outcomes and drive improvement
Partner with clinical, analytics, and business leaders to align performance measures with organizational objectives and support meaningful action
Collaborate with cross-functional teams to identify improvement opportunities, establish success metrics, and evaluate results
Support governance processes related to clinical performance measurement and prioritization
Build partnerships across clinical, operational, analytics, network, and business teams
Present recommendations and influence executive decision-making
Lead cross-functional initiatives that improve quality, cost, and member outcomes
Monitor industry trends and emerging best practices
Identify opportunities to expand enterprise clinical capabilities and deliver long-term value

Requirements

What you’ll need

Bachelor's degree
8+ years of experience in healthcare strategy, clinical strategy, healthcare consulting, population health, provider performance, value-based care or quality improvement OR 4 years of experience from a top tier consulting
Experience developing strategic recommendations using quantitative and qualitative data analysis
Experience leading cross-functional strategic initiatives and driving results across multiple stakeholders
Experience partnering with analytics teams to analyze healthcare data and generate actionable insights
Experience developing business cases and presenting recommendations to senior leadership
Demonstrated ability to influence without direct authority
Strong executive communication, presentation, and storytelling skills
Self-starter with the ability to proactively identify opportunities, solve complex problems, and manage competing priorities
Demonstrated ability to navigate ambiguity and drive results in a fast-paced environment
Advanced proficiency in Microsoft Excel and PowerPoint
Advanced degree (Master's or Doctorate) in Business (MBA), Public Health, Epidemiology, Healthcare Administration, Clinical Informatics, or a related field
Experience developing business cases, strategic roadmaps, and enterprise-level recommendations for healthcare programs and initiatives
Clinical degree or licensure (e.g., MD, DO, PharmD, APRN, NP, PA, RN, BSN)
Knowledge of healthcare claims data, clinical coding systems and taxonomies (e.g., ICD-10, CPT, HCPCS), quality measurement methodologies, performance analytics, and their application to performance measurement and improvement initiatives
Experience working with Medicare Advantage populations
Experience synthesizing evidence from peer-reviewed literature, industry research, and healthcare trends to support strategic decision-making
Home internet service with minimum 25 Mbps download and 10 Mbps upload
Ability to work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Benefits

Comp & perks

Bonus incentive plan based on company and/or individual performance
Medical benefits
Dental benefits
Vision benefits
401(k) retirement savings plan
Paid time off
Company holidays
Personal holidays
Paid parental leave
Paid caregiver leave
Short-term disability
Long-term disability
Life insurance
Internet expense payment for employees who live and work from home in California, Illinois, Montana, or South Dakota
Telephone equipment provided for Home or Hybrid Home/Office employees
Remote work arrangement
Occasional travel to Humana offices for training or meetings