{"id":1415373,"url":"https://alion.io/job/humana-measure-optimization-lead-care-coordination","title":"Measure Optimization Lead - Care Coordination","company":{"id":2742,"name":"Humana","domain":"humana.com","url":"https://alion.io/company/humana","size_band":"5000+","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Workday","truth_index":{"grade":"A","score":98,"open_postings":35,"ghost_share":0.029,"stale_share":0.086,"repost_share":0.2,"time_to_fill_p50_days":15,"computed_at":"2026-10-30T05:48:23Z"}},"role":"Communications","role_family":"Communications","seniority":"lead","employment_type":"full_time","work_mode":"on_site","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Louisville, United States","United States"],"countries":["US"],"hiring_countries":[],"hiring_countries_total":0,"salary":{"min":117600,"max":161700,"currency":"USD","period":"year","gross":null,"usd_annual":161700},"salary_estimate":null,"experience_years_min":7,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Power BI","optional":false},{"name":"SQL","optional":false},{"name":"Tableau","optional":false},{"name":"HIPAA","optional":true}],"status":"closed","first_seen_at":"2026-09-28T20:32:50Z","employer_posted_date":"2026-09-28","last_verified_at":"2026-10-27T05:49:20Z","board_verified":false,"closed_at":"2026-10-27T05:49:20Z","days_open":28,"trust":{"level":"not_scored","repost_count":null,"flags":[],"days_open":28},"description":"Become a part of our caring community\nThe Measure Optimization Lead - CC addresses complex business challenges affecting HEDIS Care Coordination measure performance. The role uses established reporting, operational knowledge, and input from internal and external partners to provide insights and recommendations to decision-makers. The Measure Optimization Lead works across initiatives of diverse scope and complexity, ranging from moderate to substantial.The CMS Stars quality rating system evaluates Medicare Advantage and Prescription Drug Plans using approximately 40 measures covering preventive care screenings, health condition management, health outcomes, patient experience, and plan operations. In this pivotal role, you will provide HEDIS subject matter expertise and strategic leadership to advance Care Coordination measure performance. You will identify improvement opportunities, guide cross-functional initiatives, and translate approved reporting and analysis into clear recommendations for leadership. Your work will directly support decision-making and Stars improvement efforts that improve member care, strengthen plan quality, and advance organizational goals.\nKey Responsibilities:\nStrategic Leadership\nLead the HEDIS Care Coordination measure optimization strategy and identify opportunities to improve performance. \nEvaluate business and operational factors affecting measure outcomes and recommend targeted improvements. \nTranslate measure requirements, performance insights, and business needs into clear priorities and implementation plans. \nLeadership Support\nPrepare high-quality materials and recommendations for vice presidents and senior leadership discussions. \nParticipate in strategic conversations, providing actionable insights and clear recommendations. \nCommunicate complex HEDIS, operational, and performance concepts in a clear and compelling manner to non-technical audiences. \nCare Coordination Improvement Initiatives\nCollaborate with quality improvement, clinical, operations, technology, analytics, and vendor teams to assess and enhance Care Coordination measure performance. \nLead initiatives from opportunity identification and business requirements through implementation and continuous improvement. \nIdentify and resolve business and operational barriers affecting workflows, supplemental data pathways, source connectivity, and ownership. \nAct as a HEDIS subject matter expert, explaining measure requirements, methodology, and performance implications. \nPartner with analytics teams to frame business questions, interpret approved analyses, and translate findings into practical recommendations. \nBusiness Reporting and Communication\nDefine business reporting requirements and success measures for Care Coordination initiatives. \nUse established dashboards and reporting to communicate key metrics, trends, risks, and improvement opportunities. \nPromote accuracy, consistency, and clarity in business materials and executive communications. \nUse your skills to make an impact\nRequired Qualifications\nBachelor’s degree\n7 or more years of experience in data analysis and/or business intelligence\n3 or more years of experience with Medicare Advantage, Stars programs, HEDIS measures, or healthcare quality improvement\nStrong understanding of CMS Star Ratings\nExperience with business intelligence tools such as Power BI, Tableau, Qlik, SQL, or similar platforms\nExperience defining business questions and requirements for analytical and technical partners\nAbility to interpret reporting and analytical findings, identify root causes and performance drivers, and translate insights into practical recommendations\nProven ability to work across business, clinical, operational, technology, analytics, and vendor teams\nExperience leading complex initiatives, managing accountability, resolving issues, and influencing outcomes without direct authority\nExcellent communication and presentation skills, with the ability to convey complex concepts clearly to senior leadership\nPreferred Qualifications\nExperience with Care Coordination measures, including Follow-Up After Emergency Department Visit, Transitions of Care, and Plan All-Cause Readmissions. \nExperience with payer claims data, clinical data, supplemental data, medical record review, or HEDIS audit support. \nExperience working with healthcare vendors and enterprise technology partners. \nAdvanced degree in healthcare administration, public health, business, analytics, or a related discipline. \nAdditional Information\nTo ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:\nAt minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested\nSatellite, cellular and microwave connection can be used only if approved by leadership\nEmployees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.\nHumana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.\nWork from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information\nAs part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.\nHumana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from  with instructions on how to add the information into your official application on Humana’s secure website.\nScheduled Weekly Hours\n40Pay Range\nThe 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.$117,600 - $161,700 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.Description of Benefits\nHumana, 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About Us\nAbout 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\nIt 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.","description_format":"text","description_chars":8610,"description_truncated":false,"requirements":{"experience_years_min":7,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"bachelor","optional":false},"security_clearance":false,"languages":[]},"benefits":["Life insurance","Retirement plans"],"hiring_locations":[],"hiring_excludes":[],"relocation_offered":false,"industries":["Care Coordination & Population Health","Home Care Services","Primary Care & Medical Centers","Pharmacies"],"lifecycle":[{"event":"open","at":"2026-09-28T20:32:50Z"},{"event":"close","at":"2026-10-27T05:49:20Z"}],"visa":[{"country":"US","licensed_sponsor":true,"evidence":"H-1B filings in 12 months: 339 · green card filings: 89","filings_12m":339,"filings_prev_12m":256,"green_card_filings_12m":89,"median_offered_wage_usd":137500,"route":null,"cap_exempt":false,"checked_at":"2026-10-29T16:27:21+00:00","sources":["US Department of Labor: LCA disclosure data (H-1B, H-1B1, E-3)","US Department of Labor: PERM disclosure data (green cards)"],"filings_for_role_12m":0}],"liveness":null,"pay":{"stated_usd_annual":161700,"is_top_pay":true},"html_url":"https://alion.io/job/humana-measure-optimization-lead-care-coordination","json_url":"https://alion.io/job/humana-measure-optimization-lead-care-coordination.json","meta":{"generated_at":"2026-10-30T13:37:41Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":703,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-10-31T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.02,"usd":0.002,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":2742},"rest":"https://alion.io/mcp/rest/get_company?id=2742"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fhumana-measure-optimization-lead-care-coordination"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"live","price":{"credits":1,"usd":0.1},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fhumana-measure-optimization-lead-care-coordination"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.02,"usd":0.002},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fhumana-measure-optimization-lead-care-coordination"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/humana-measure-optimization-lead-care-coordination\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fhumana-measure-optimization-lead-care-coordination"}],"agent":{"mcp":"https://alion.io/mcp/jobs","mcp_open":"https://alion.io/mcp/open","next":[{"tool":"get_job","arguments":{"id":1415373}},{"tool":"search_jobs","arguments":{"company":"humana.com","detail":"compact"}},{"tool":"match_people","arguments":{"job_id":1415373},"note":"people open to offers who fit this vacancy"}],"note":"The same data through MCP tools: https://alion.io/mcp/open needs no sign-in (compact searches, postings, people); https://alion.io/mcp with an Alion account has everything. Docs: https://alion.io/developers"}}