Title: Behavioral Health Medical Director Location: Remote, Louisiana Remote Job: Remote Job: Yes Widget: Full time Category: Physician Humana Job ID: R-411376 Job Description: Description Become a part of our caring community The Behavioral Health Medical Director responsible for behavioral health care strategy and/or operations. The Behavioral Health Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors. The Behavioral Health Medical Director may develop procedures, processes, productivity targets, and new delivery models. Maintains efficient operations while ensuring attainment of quality of care and financial goals. Provides information for pricing guidelines based on utilization patterns and client demographics. Makes decisions on moderately complex to complex issues regarding technical approach for project components, and work is performed without direction. The Behavioral Health Medical Director actively uses their medical background, experience, and judgement to make determinations whether requested services, requested level of care, and/or requested site of service should be authorized. All work occurs with a context of regulatory compliance, and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal teaching conferences, and other sources of expertise. The Behavioral Health Medical Directors will learn Medicare, Medicare Advantage and/or Medicaid requirements, and will understand how to operationalize this knowledge in their daily work. The Behavioral Health Medical Director may speak with contracted external physicians, physician groups, facilities, or community groups to support regional market priorities, which may include an understanding of Humana processes, as well as a focus on collaborative business relationships, value-based care, population health, or disease or care management. The Behavioral Health Medical Directors support Humana values, and Humana’s Bold Goal mission, throughout all activities. Use your skills to make an impact Required Qualifications • MD or DO degree • 5+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in an inpatient environment and/or related to care of a Medicare or Medicaid type population • Current and ongoing Board Certification an approved ABMS Medical or ABPN Specialty • A current and unrestricted license in at least one jurisdiction and willing to obtain additional license, if required. • No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements. • Excellent verbal and written communication skills . • Evidence of analytic and interpretation skills, with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post acute services such as inpatient rehabilitation. Preferred Qualifications • Knowledge of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other Medical management organizations, hospitals/ Integrated Delivery Systems, health insurance, other healthcare providers, clinical group practice management. • Utilization management experience in a medical management review organization, such as Medicare Advantage, managed Medicaid, or Commercial health insurance. • Experience with national guidelines such as MCG® or InterQual • Psychiatry, Internal Medicine, Family Practice, Geriatrics, Hospitalist, or Emergency Medicine clinical specialists • Advanced degree such as an MBA, MHA, MPH• Exposure to Public Health, Population Health, analytics, and use of business metrics. • Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health. • The curiosity to learn, the flexibility to adapt and the courage to innovate Additional Information Typically reports to a Regional Vice President of Health Services, Lead, or Corporate Medical Director, depending on size of region or line of business. #physiciancareers Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required. 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. $223,800 - $313,100 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. 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.

• Owning EMR review across our trial portfolio. • Working with engineering to refine our automated EMR screening. • Encoding eligibility criteria for new sponsor-direct trials. • Strategic medical leadership across the company. • Attending weekly customer meetings on our sponsor-direct trials. • Driving improvements across our portfolio. • Partnering across the team.

• Provides medical oversight of assigned clinical studies in the duty as a medical monitor • Often serves as primary medical contact for customers for assigned clinical studies • Responsible for protocol design and development, upon request • Provides medical and therapeutic input to Study Start Up, Feasibility, and Subject Identification efforts • Presents identified trends and issues to customers and project team members

Role Description Join the team transforming care for people with immune challenges, rare diseases, cancers, and neurological conditions. In Specialty Care, you’ll help deliver breakthrough treatments that bring hope to patients with some of the highest unmet needs. The Director, Medical Portfolio Strategy and Solutions, Population Health is accountable for leading development of the medical engagement strategy for US IDN Health System & Population Health, organized customers and other population health stakeholders, to include: - Insight generation - Population health initiatives - Scientific content and educational program development An important element of this role is to drive innovation with medical initiatives and simplify and enhance the customer engagement experience through impactful and personalized content tailored to organized customer needs and preferences. Main Responsibilities - Develop the medical engagement strategy, including educational initiatives and related content, tools and resources, intended for payer and population health decision makers and other organized customers. - Develop population health related initiatives aimed at helping population health stakeholders improve quality of care and health outcomes, in collaboration with relevant internal stakeholders. - Develop and implement non-CME medical education programming, including through partnerships with professional societies such as AMCP and ASHP. - Drive innovation with customer engagement approaches by leveraging AI, digital technologies, and emerging platforms to enhance scientific communications and create more personalized, impactful interactions and a consistent customer journey. - Serve as therapeutic area subject matter expert for scientific engagement with strategic accounts, develop and deliver educational programming for population HCDMs, and represent MVO function at payer and scientific congresses. - Ensure content strategy and materials are aligned with TA scientific communication plans and Specialty Care Market Access stakeholders. - Lead and coordinate Early Scientific Dialogue consultancies with organized customers, collaborating closely with internal stakeholders to ensure insights shared with relevant stakeholders are pulled through into integrated evidence generation plans. - With support of project management, manage content workflow from MedHub and Vendor into appropriate review process and content management library. - Coordinate with Field Team leaders and Medical Excellence roles to optimize content usage, customer experience, and employee experience. - Contribute to the evolution of medical omnichannel engagement by building and enabling capabilities that facilitate a fully integrated channel content strategy. - Leverage AI-powered solutions and digital resources to enhance data analysis, content personalization, and customer engagement effectiveness. - Leverage customer insights, market research and multiple data sources to identify innovative educational and content opportunities. - Collaborate with Global Sci Com, Global and US medical teams, Med Hub, and vendors to ensure synergies with content development, build cross-portfolio consistency with MVO team content and resources, and partner across business units with medical outcomes functions on common above brand resources. - Develop and manage the payer medical consultant panel, insight generation initiatives and analytics, and other advisory panels or market research. - Work with Global medical publications and TA stakeholders to develop relevant local publications directed at US payer and population HCDM audience. - Partner with Global Medical Information to develop specific healthcare economic information SRDs relevant for US payer and population health stakeholders. - Collaborate with HEVA to provide input and medical review of economic models, BIMs, dossiers, and patient estimator tools. - Collaborate with Independent Medical Education to support the review of payer-related educational grant requests and opportunities for population health and payer HCDM-focused education. - Collaborate with Public Affairs and TA medical units to coordinate opportunities to support scientific engagement with PAG Leadership. - Participate in and actively contribute to integrated evidence generation planning process to ensure the US payer and population HCDM voice is included in US evidence gap analysis. - Contribute to organized customer evidence generation partnerships as key member of project team, serving as TA and Strategy subject matter expert with customer. - Serve as medical partner to Value & Access brand leads and other stakeholders to provide input on product value proposition, ensure alignment on customer engagement plans, and support account team training as appropriate. - Facilitate field MVO team integration and alignment with key stakeholders including TA medical unit, Value & Access, and HEVA, including representation with medical brand planning across TA teams. - Provide comprehensive field team support and training, including leading the development of training materials, facilitation of TA and product training and certifications, and management of proactive scientific exchange training requirements. - Serve as medical reviewer for payer facing resources, as requested and when appropriate. - Develop performance and impact measures for prioritized field medical initiatives including tools to capture insights on customer receptivity to scientific content and value proposition. - Conduct US tiering of non-HCP payer and HEOR consultants for Specialty Care business unit. - Lead a team of MVO advisors that provide field input and customer insights to inform the development of medical initiatives, content, and resources, in partnership with field leadership advisor and other key stakeholders. - Plan and manage program budgets. - Ensure compliance with all local regulations. Qualifications - Advanced degree in healthcare or related scientific discipline (PharmD, MD, PhD, MS, etc.) required; MBA or relevant business background a plus. - Relevant experience in a specialty care therapeutic area of focus (immunology, neurology, oncology, rare blood disorders). - Deep understanding of US healthcare delivery dynamics across health systems, payers, providers, and other key influencers. - At least 3 years of experience in the pharmaceutical industry. - At least 2 years of experience in medical strategy, content development and design, and scientific communications. - Strong business acumen. Professional Qualifications and Skills - Experience with omnichannel communications and scientific content development including storytelling, creativity, design, written, verbal and presentation skills. - Deep knowledge of US healthcare delivery landscape and defining opportunities for scientific partnerships with key stakeholders to improve health outcomes. - Ability to leverage adult learning principles to maximize content effectiveness. - Strong planning and project management skills, with ability to prioritize and work independently on simultaneous projects. - Analytical and detail oriented, pragmatic in solving problems. - Proficiency in Microsoft O365 office suite applications as well as content creation software. - Knowledge of AI applications and digital technologies for enhancing scientific communications and customer engagement. - Proven ability to work in a fast-paced, change-oriented environment. - Willingness and ability to lead or facilitate collaboration across functions, global and local, and within Commercial team. - Commitment to policy, procedure, and precise documentation. - Respect for diversity of thought. - Awareness and understanding of content management systems and processes (Veeva CRM, CLM, PromoMats, etc.). Local Specificities - Travel approximately 20-25% required for field-related responsibilities, internal meetings, appropriate engagement with internal stakeholders, and participation in relevant congresses and professional meetings. - Field-based position with therapeutic area subject matter expert responsibilities. - Dedicated leads defined by therapeutic area with defined responsibility for above brand and cross-portfolio initiatives and resources. - Requires deep understanding of US healthcare delivery dynamics and strong expertise in scientific content development, omni-channel and digital engagement and project management. - Position serves as key partner for integrating with TA medical units, Value & Access TA and brand, and other key internal stakeholders. Benefits - Bring the miracles of science to life alongside a supportive, future-focused team. - Discover endless opportunities to grow your talent and drive your career, whether it’s through a promotion or lateral move, at home or internationally. - Enjoy a thoughtful, well-crafted rewards package that recognizes your contribution and amplifies your impact. - Take good care of yourself and your family, with a wide range of health and wellbeing benefits including high-quality healthcare, prevention and wellness programs and at least 14 weeks’ gender-neutral parental leave.