Oncology Program Lead

About the role

The Oncology Program Lead designs, implements, and optimizes clinical programs that drive quality, safety, and efficiency across healthcare delivery systems. The Clinical Strategy and Program Development Lead works on problems of diverse scope and complexity ranging from moderate to substantial. This role drives improvements in patient outcomes, quality, cost efficiency, and service delivery.

Responsibilities

• Vendor Strategy & Performance Management:
  • End-to-end management of the oncology UM vendor, including performance oversight, governance, and strategic alignment
  • Establish contractual KPIs, SLAs, and quality metrics to ensure delivery of safe, effective, and efficient care
  • Analyze vendor performance data, identify trends, and drive continuous improvement initiatives
  • Conduct regular business reviews and performance discussions with vendor leadership
  • Drive timely closure of IOPs and CAPs
• Clinical & Operational Oversight:
  • Ensure adherence to evidence-based oncology guidelines, UM policies, and regulatory standards
  • Partner with internal clinical, operations, and compliance teams to optimize workflows and program outcomes
  • Evaluate vendor clinical processes and recommend enhancements to improve quality, consistency, and patient experience
  • Serve as a subject matter expert in oncology UM programs and clinical operations
• Program Leadership & Execution:
  • Lead complex initiatives and projects supporting oncology UM program optimization
  • Define program objectives, timelines, resource needs, and success metrics; manage execution end-to-end
  • Utilize data and analytics to inform decision-making and identify opportunities for efficiency and cost savings
  • Drive innovation and scalability within vendor-supported programs
• Contract & Relationship Management:
  • Support contract development, negotiation, and ongoing management of vendor agreements
  • Monitor compliance with contractual obligations and address gaps or risks proactively
  • Investigate and resolve invoice, performance, and contractual discrepancies
  • Build and maintain strong, collaborative relationships with vendor partners and internal stakeholders
• Cross-Functional Collaboration & Influence:
  • Collaborate across departments including Clinical, Network, Finance, Compliance, and Operations
  • Lead stakeholder forums, executive updates, and cross-functional meetings

Qualifications

• Registered Nurse (RN)
• 7+ years of experience in vendor management, program management, or clinical operations
• 3-5 years or more of oncology experience in case management, utilization management or quality review or auditing
• Experience applying clinical guidelines and medical policies
• Proven ability to manage complex programs and drive performance outcomes
• Advanced analytical, problem-solving, and decision-making skills
• Proficiency in Microsoft Office tools (Excel, Word, Outlook); ability to work with data systems and reporting tools

Desired Qualifications

• Master’s degree in Nursing, Healthcare Administration, Public Health, or related field
• Experience working with oncology UM vendors or specialty benefit management programs

Additional Information

• 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 required; wireless, wired cable or DSL connection is suggested.
• In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Application Deadline

08-03-2026