Sr. Maternal Health Professional

$71,100 - $97,800 / year

Become a part of our caring community and help us put health first

The Senior Maternal Health Professional contributes to administration of care management. Provides non-clinical support to the assessment and evaluation of members' needs and requirements to achieve and/or maintain optimal wellness state by guiding members/families toward and facilitate interaction with resources appropriate for the care and wellbeing of members. The Senior Maternal Health Professional work assignments involve moderately complex to complex issues where the analysis of situations or data requires an in-depth evaluation of variable factors.

Maternal Health Support Professional Lead Role

Collaborate with Leadership and Associate Director to design and implement short- and long-term Maternal and Child Health action plans with measurable goals
Identify, prioritize, and advance new Maternal and Child Health initiatives to address gaps in care, member needs, and regulatory requirements
Establish and maintain partnerships with community organizations, provider networks, and state agencies to enhance service delivery and strengthen access pathways for Humana members
Represent Humana Maternity at community events, forums, and collaborative workgroups
Be a proxy for the Maternal and Child Health Department in advisory councils, DMAS Maternal workgroups, and other important meetings, such as the Neonatal/Perinatal Collaborations through the VNPC
Travel to and participate in provider and community events to promote Humana's Maternal and Child Health programs
Together with the AD, the lead will support maternity managers in preparing and submitting regulatory reports
Work with leadership to identify access to care challenges, including process improvement, resource building, and collaborations
Develop and maintain tracking systems and methodologies for Maternal and Child Health initiatives, including data collection on outcome measures and program effectiveness and compliance
Analyze and interpret data to assess impact, inform continuous improvement, and fulfill reporting requirements
Be the subject matter expert on maternal child health topics for internal teams, providing guidance on strategy, best practices, and policy interpretation
Collaborate with the Associate Director of Maternal and Child Health to lead internal policy and procedure updates
Collaborate with internal teams and DMAS to improve maternal and behavioral health initiatives, providing recommendations and submitting detailed reports in accordance with DMAS requests.
Advises and guides multiple internal teams, providing advances subject matter expertise and leading the implementation of innovative models for integrates maternal health care.
Ensure that all maternal health operations not only meet, but exceed, regulatory, contractual and accreditation requirements, supporting a culture of continuous improvement and compliance across the organization.
Monitors, analyzes and interprets emerging maternal health equity trends, providing strategic advice to senior executives and commending transformative opportunities across the enterprise.
Leads performance measurement and quality improvement efforts, sponsoring data-driven decision making around network adequacy, utilization, member outcomes, and health equity objectives.
Facilitates strategic advisory councils, learning collaboratives, and community forums, establishing Humana as a trusted partner in maternal health innovation.

Use your skills to make an impact

Required Qualifications

Must reside in the Commonwealth of Virginia, preferably the Central Region (Richmond, Tidewater) or NOVA
Demonstrated experience in large Care Management and Maternal Health implementation.
Active RN license in the Commonwealth of Virginia, with no disciplinary action OR, LCSW, MSW, BSW, LSW, LPC
5 years of experience in maternal health, healthcare transformation, integrated care or related disciplines.
5+ years of technical experience using Microsoft Office, Word, Excel, Outlook
Experience in problem solving and consultation with complex environments.
Strong influencing and process improvement skills
Ability to influence department's strategy
Ability to communicate effectively and deliver presentations to senior leaders.
Demonstrates decision making on moderately complex to complex issues

Preferred Qualifications

Bachelor's degree or Master's degree
High-level administrative experience with navigating and/or overseeing state's safety net maternal health programs and services through the LGEs, or a similar infrastructure of state-designated local maternal health organizations.
Knowledge of community resources and behavioral health practices with high-risk populations.
Process knowledge and designed experience.

Additional Information

Workstyle: This is a Remote position that requires some travel.
Travel: Up to 25% of the time to Humana Healthy Horizons office in Glen Allen, VA for collaboration and face to face meetings as well as field interactions with providers, members, and their families. Note: Travel may exceed 25% in the initial stages of market implementation.
Typical Workdays and Hours: Monday – Friday; 8:00am – 5:00pm Eastern Standard Time (EST).
Direct Reports: Up to 15.
Language Proficiency Assessment: Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.

Work at Home Internet Statement

To 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:

At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
Satellite, cellular and microwave connection can be used only if approved by leadership.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Interview Format

As 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.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

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.

$71,100 - $97,800 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

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

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.

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Tower Health Philadelphia, PA

Job Summary St. Christopher's Hospital for Children is seeking a Full time Experienced Pediatric Primary Care Nurse Practitioner in our Center for the Urban Child to join our team. St. Christopher’s Hospital for Children A leader in pediatric care since 1875, St. Christopher's Hospital for Children's nationally recognized programs and pediatric specialists provide exceptional care to children from throughout the Greater Philadelphia area and around the world. The mission of St. Christopher's Hospital for Children is to provide quality pediatric services in a caring, progressive environment. St. Christopher's Hospital is committed to quality through teamwork, technology and service in a child-friendly, family-oriented environment. Caring for children is our passion. Here, we develop, offer, and refine nationally recognized programs through patient- and family-centered, collaborative, and innovative care. We’re an academic medical center, which means we bring you the latest in diagnostics, treatments, and innovations — all tailored specifically to the needs of your child. Through our research, academics, and clinical care, children and families depend on the leading-edge care found only at an academic medical center. In joining St. Christopher’s you’ll enjoy: Work/life balance and flexibility Teaching, quality improvement and strategic development opportunities The latest in diagnostics, treatments, and innovations EMR System: EPIC Team-based care with dedicated support staff Benefits & Perks: Competitive compensation package Comprehensive benefits including health, dental, vision, life and disability insurance Retirement savings plan with employer automatic contribution and employer match. Malpractice insurance & tail coverage Paid time-off allowance Commuter Benefits- tax-free transit or parking CME time and money Supportive health system to advance goals Contact Person Name: Lisa Wortman Contact Phone Number: 484-628-0556 Contact Email: Lisa.Wortman@towerhealth.org #LI-KE1 #STC Putting Kids and Families First Since 1875 A leader in pediatric care since 1875, St. Christopher's Hospital for Children's nationally recognized programs and pediatric specialists provide exceptional care to children from throughout the Greater Philadelphia area and around the world. The mission of St. Christopher's Hospital for Children is to provide quality pediatric services in a caring, progressive environment. St. Christopher's Hospital is committed to quality through teamwork, technology and service in a child-friendly, family-oriented environment. For more than 100 years, our hospital has served children, families, and communities in Greater Philadelphia and surrounding communities. Caring for children is our passion. Here, we develop, offer, and refine nationally recognized programs through patient- and family-centered, collaborative, and innovative care. We’re an academic medical center, which means we bring you the latest in diagnostics, treatments, and innovations — all tailored specifically to the needs of your child. Through our research, academics, and clinical care, children and families depend on the leading-edge care found only at an academic medical center. The Community Philadelphia located between New York and Washington D.C, is considered to be the birthplace of the United States. The Constitution was debated here in Philadelphia in what is now the Independence Hall. The nearby Liberty Bell Center is home to the famous two-thousand-pound bell which became a symbol of freedom. The National Constitution Center also tells the story of 1920s prohibition. Learn more about Al Capone and other famous former inmates at the Eastern State Penitentiary. The Philadelphia Museum of Art, one of the country's largest museums, is not to be missed. At Fairmount Park, discover outdoor art on the Benjamin Franklin Parkway, as well as the Smith Memorial Arch dedicated to Civil War heroes. Attractions for kids include Philadelphia Zoo, the oldest zoo in America. Meet more animals at the Academy of Natural Sciences or enjoy fun and educational interactive displays at the Please Touch Museum. Videos: Virtual Tour – St. Chris Virtual Tour of Philadelphia Websites: St. Christopher’s Hospital for Children City of Philadelphia Qualifications Education Requirements Master's Degree Experience Relevant Experience Certification and Licensure PA Registered Nurse License PA Certified Registered Nurse Practitioner License Required Skills Excellent Communications Skills Excellent Interpersonal Skills Leadership Skills Overview Tower Health is a regional integrated healthcare system that offers compassionate, high-quality, leading-edge healthcare and wellness services to communities in Berks, Chester, Montgomery, and Philadelphia Counties. With approximately 11,500 employees, Tower Health consists of Reading Hospital in West Reading; Phoenixville Hospital in Phoenixville; Pottstown Hospital in Pottstown; and St. Christopher's Hospital for Children in Philadelphia. Tower Health has partnered with Drexel University College of Medicine to open a new medical school one-half mile walking distance from Reading Hospital, a regional medical campus for Drexel University College of Medicine at Tower Health. The school opened in 2021 and is currently accepting enrollment applications for the second class in 2024. In addition, Reading Hospital is the main training hospital for the medical school and supports ACGME accredited residency and fellowship programs. For more information, visit towerhealth.org