VP, Medicare Market Operations and Business Performance

Become a part of our caring community The Vice President, Medicare Market Operations & Business Performance is an enterprise leader responsible for driving market-level operating performance, financial outcomes, and strategic execution across the organization’s Medicare Advantage Regions.This role leads a data-driven performance management model across Medicare markets, translating complex operational, financial, clinical, and consumer data into actionable strategies that improve growth, profitability, quality outcomes, and member experience.The VP partners closely with regional market leadership, actuarial, finance, network, clinical operations, Stars, and enterprise analytics to identify performance gaps, prioritize operational interventions, and accelerate results.               Key Responsibilities Include:Enterprise Medicare Market Performance LeadershipLead enterprise oversight of Medicare market operational and financial performance across multiple geographies.Drive accountability for membership growth, medical cost performance, quality outcomes, and operating margin.Data-Driven Performance ManagementTranslate large-scale operational, financial, and clinical data into strategic insights and market interventions.Identify emerging trends in medical cost, utilization, risk adjustment, and member engagement and deploy targeted performance improvement strategies.Financial & Operational ExecutionPartner with finance and actuarial leaders to manage Medical Loss Ratio, administrative cost efficiency and margin improvement.   Cross-Enterprise CollaborationAlign operational priorities across the enterprise to ensure consistent delivery of Medicare strategy at the market level.Market Intelligence & Strategic InsightMonitor competitive market dynamics, regulatory developments, and demographic trends affecting Medicare markets.LeadershipBuild and lead a high-performing team responsible for Medicare market analytics, operational strategy, and performance governance.Foster a culture centered on accountability, transparency, and data-driven decision making.Use your skills to make an impact  Required Qualifications:Bachelor’s degree required; MBA, MHA, MPH, or related graduate degree strongly preferred15+ years of leadership experience in healthcare or health insuranceDeep experience in Medicare Advantage operations and market performance managementDemonstrated success managing large-scale operational and financial performance in complex, matrixed organizationsExperience driving enterprise performance improvement initiatives using advanced analyticsStrong familiarity with Medicare regulatory, reimbursement, and quality frameworksEnterprise strategic thinkingAdvanced financial and analytical acumenExecutive communication and stakeholder influenceAbility to translate data into actionable business strategyProven ability to lead transformation across highly matrixed organizationsTravel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.Scheduled Weekly Hours40Application Deadline: 06-13-2026About us About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.​Equal Opportunity EmployerIt 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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.