Job Details
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 Leadership**
+ Lead 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 Management**
+ Translate 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 Execution**
+ Partner with finance and actuarial leaders to manage Medical Loss Ratio, administrative cost efficiency and margin improvement.
**Cross-Enterprise Collaboration**
+ Align operational priorities across the enterprise to ensure consistent delivery of Medicare strategy at the market level.
**Market Intelligence & Strategic Insight**
+ Monitor competitive market dynamics, regulatory developments, and demographic trends affecting Medicare markets.
**Leadership**
+ Build 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 preferred
+ 15+ years of leadership experience in healthcare or health insurance
+ Deep experience in Medicare Advantage operations and market performance management
+ Demonstrated success managing large-scale operational and financial performance in complex, matrixed organizations
+ Experience driving enterprise performance improvement initiatives using advanced analytics
+ Strong familiarity with Medicare regulatory, reimbursement, and quality frameworks
+ Enterprise strategic thinking
+ Advanced financial and analytical acumen
+ Executive communication and stakeholder influence
+ Ability to translate data into actionable business strategy
+ Proven ability to lead transformation across highly matrixed organizations
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
Application Deadline: 06-02-2026
**About 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.
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**Equal Opportunity Employer**
It 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.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
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 Leadership**
+ Lead 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 Management**
+ Translate 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 Execution**
+ Partner with finance and actuarial leaders to manage Medical Loss Ratio, administrative cost efficiency and margin improvement.
**Cross-Enterprise Collaboration**
+ Align operational priorities across the enterprise to ensure consistent delivery of Medicare strategy at the market level.
**Market Intelligence & Strategic Insight**
+ Monitor competitive market dynamics, regulatory developments, and demographic trends affecting Medicare markets.
**Leadership**
+ Build 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 preferred
+ 15+ years of leadership experience in healthcare or health insurance
+ Deep experience in Medicare Advantage operations and market performance management
+ Demonstrated success managing large-scale operational and financial performance in complex, matrixed organizations
+ Experience driving enterprise performance improvement initiatives using advanced analytics
+ Strong familiarity with Medicare regulatory, reimbursement, and quality frameworks
+ Enterprise strategic thinking
+ Advanced financial and analytical acumen
+ Executive communication and stakeholder influence
+ Ability to translate data into actionable business strategy
+ Proven ability to lead transformation across highly matrixed organizations
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
**Scheduled Weekly Hours**
40
Application Deadline: 06-02-2026
**About 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 Employer**
It 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.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
Job #NLX292339810