Humana Market Medical Officer, Commercial


Non clinical

Role: Market Medical Officer, Commercial

Location: Work at Home GA & TN

Travel: 50%

The MMO, Commercial provides insight & thought leadership to develop/maintain relationships across the healthcare ecosystem with a focus on Employer Group Segment. This role supports business line clinical management goals & provides visibility & growth of the Humana brand across commercial/business clients, provider communities, nonprofit & government sectors.

Responsibilities • Ensures Humana Clinical Value Proposition is well represented • Develops/maintains relationships among stakeholders enhancing the Humana business model • Works across the organization to provide medical interpretation & advise leadership on clinical strategies • Engages key client groups on clinical performance, facilitates discussion of clinical reporting & action planning • Key clinical support for specific employer groups & the book of business • Plays a key role in segment finalist presentations • Analyzes segment & market level trends, & brings innovative/engaging initiatives to clients driving trend mitigation strategies • Provides clinical reviews for medical underwriting analyses • Drives integrated multidisciplinary engagement to address improving cost & quality of care • Contact for critical partner relationships with organized medicine, industry partners & state & local health care leaders. Acts as key influence & thought leader in local markets.

Requirements • Current unrestricted license in one state & willing to obtain others as needed • MD or DO degree • Board Certified in an ABMS Medical Specialty • 5 years medical management experience within health insurance organizations including external facing responsibilities • Excellent communication & presentation skills • Knowledge of Managed Care Commercial products • Possess analytic & interpretation skills with prior experience leading to externally focused programs to improve &/or address quality, cost & social determinants of health

Posted December 20, 2021