Director, Group Medicare Account Management

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 The Director, Group Medicare Account Management is a strategic people-leader role responsible for translating the Group Medicare client engagement strategy into consistent execution across an assigned portfolio, team, or functional area. Reporting to the Associate Vice President of Client Engagement & Excellence, the Director leads account management performance, client retention, experience, renewal readiness, and continuous improvement within the scope of responsibility.

The Director, Group Medicare Account Management advances Account Management from relationship management toward disciplined value delivery by establishing clear operating practices, coaching leaders and associates, and coordinating cross-functional partners to achieve measurable client, member, financial, and operational outcomes.

Key responsibilities include coordinating cross-functional teams, managing complex client portfolios, and proactively identifying opportunities for process enhancements that improve service delivery. The Director also serves as a key point of contact for issue resolution, contract renewals, and strategic consultation, ensuring that client expectations align with organizational capabilities and regulatory requirements.

The role has full accountability for:

• Retention, renewal, and experience performance for the assigned client portfolio
• Client and Member Net Promoter Score (NPS) improvement within the area of responsibility
• Account Management team effectiveness, capacity, and consistent execution
• Senior client relationships, governance, and issue escalation
• Cross-functional coordination to deliver service, Stars, network, enrollment, and financial commitments

Enterprise Client Ownership & Value Delivery:

• Lead client value delivery for an assigned portfolio, team, or functional area, with accountability for retention, renewal readiness, experience, and growth execution
• Apply the portfolio segmentation and service strategy established by the Associate Vice President, tailoring account plans based on risk, value, and client needs
• Build senior relationships with priority clients and lead governance forums, business reviews, and escalated issue resolution
• Translate enterprise priorities including growth, Stars, margin discipline, and experience—into team goals and client-specific actions
• Identify emerging risks and opportunities and recommend interventions to the Associate Vice President
• Stars Activation – engage clients to promote/educate members on importance of Stars/clinical actions to improve health outcomes and CMS Stars metrics
• Cultivate and maintain strong relationships with key clients, brokers, and internal stakeholders to support retention and growth initiatives to improve NPS.
• Collaborate cross-functionally with actuarial, clinical, legal, pharmacy, and operations teams to deliver optimal solutions for clients and address complex client needs.
• Ensure adherence to all relevant regulations and contractual obligations within Group Medicare offerings.
• Provide regular updates to customers on Humana initiatives, CMS updates, news releases and Industry matters (e.g. Inflation Reduction Act, Bridge, Risk Score Normalization changes).
• Collaborating with cross-functional teams, leveraging subject matter expertise to address complex issues, and facilitating informed decision-making to drive optimal outcomes. Consistent communication and a focus on continuous improvement.
• Legal mindset to mitigate risks and maintain contract integrity. When necessary, participating in escalated legal issues by providing research and documentation
• Support Group Medicare team by close market collaboration regarding provider network negotiations and terminations that impact client retention and member satisfaction outcomes
• Monitor account performance, financial metrics, and client satisfaction to inform business decisions and continuous improvement.
• Responsible to develop and obtain legal approval for Contract Amendments, secure renewal package signatures to solidify Humana's legal protection for products and rates sold
• HR functions (i.e. performance evaluations of Sr. AEs, AEs and CEPs, timesheets, staffing)
• Daily oversight of ongoing client relationship management expectations

Strategic Initiatives Ownership

This leader will lead or co-lead initiatives within the assigned scope, including:

• Client Experience Improvement: Execute NPS action plans, improve first-year onboarding, and strengthen service consistency
• Account Management Effectiveness: Implement portfolio segmentation, optimize caseloads, and build team capabilities
• Renewal Excellence: Improve renewal readiness, pricing coordination, negotiation support, and margin discipline
• Service Model Optimization: Standardize delivery practices, reduce avoidable customization, and improve efficiency
• Retention & Loyalty: Strengthen at-risk account management, client tenure, and strategic partnership execution
• Governance & Reporting: Maintain dashboards, operating reviews, and transparent reporting for portfolio performance

Cross-Functional Integration & Execution

• Coordinate execution across Sales, Pricing, Finance, Network, Stars, Clinical, Operations, Digital, Marketing, and Product partners
• Clarify ownership, milestones, and escalation paths for renewals, repricing, network changes, advocacy efforts, and Stars initiatives
• Resolve cross-functional barriers within the Director's authority and elevate enterprise-level decisions to the Associate Vice President
• Promote end-to-end accountability and transparent reporting for client outcomes
• Participation in new client assignments and ongoing case load discussions tied to assignments for AEs.
• Oversee the execution of renewal/contract negotiations for existing clients/consultants and new clients with the assistance of key internal Subject Matter Experts (SME) and legal.
• Oversee Renewal RFP activities, ensure that strategy and direction are being carried out in proposal contents; work with SMEs on complex, custom requirements; read and edit RFPs before external submission
• Lead renewal planning and execution for the assigned portfolio, ensuring accurate, timely, and competitive renewal deliverables
• Coordinate with Sales, Pricing, Finance, Product, and Account Management leaders to develop recommendations that balance retention, affordability, and margin expectations
• Support or lead negotiations within delegated authority and escalate material tradeoffs or exceptions to the Associate Vice President
• Monitor renewal milestones, risks, and dependencies; implement recovery plans when performance is off track
• Ensure effective execution of plan build, client communications, enrollment readiness, and post-renewal follow-through
• Provide support partnership with internal/vendor leaders to the Account Executive to present new products and services to clients (e.g., new clinical programs, initiatives, annual benefit changes, annual CMS changes)

Implementation:

• Oversee and approve implementation plan to ensure client expectations are met
• Oversee implementation of new business and renewals with Sr. AE/AE/CEP. Participate in the initial implementation set-up and planning meeting activities with the new account. Provide ongoing management support to Sr. AE/AE/CEP during implementation. Interact with Group Medicare Operations leadership as needed
• Serve as an escalation point for account management, GM Sales Executive, implementation team, internal partners and client. Engage in development and delivery of external messaging on sensitive subject matters.

AI Enablement & Intelligent Automation

• Implement approved AI and automation capabilities across Account Management workflows to improve productivity, consistency, and client experience
• Identify high-value use cases in renewal preparation, client reporting, meeting follow-up, member engagement, and knowledge management
• Partner with Digital, IT, Enterprise AI, Compliance, and business teams to pilot, adopt, and scale solutions within enterprise standards
• Track adoption and value measures such as reduced administrative workload, improved cycle times, increased capacity, quality, and client satisfaction
• Build team fluency through training, workflow integration, and responsible-use expectations
• Recommend future capabilities and investment priorities to the Associate Vice President

Client & Member Experience (NPS Ownership)

• Drive Client and Member NPS improvement for the assigned portfolio or functional area
• Analyze feedback, service data, and root causes to prioritize practical experience improvements
• Lead improvements in onboarding, service consistency, first-call resolution, communications, and outreach
• Partner with Customer Service, Digital, and Operations to implement coordinated, measurable improvements across the client and member journey
• Lead continuous improvement in member engagement, communications, enrollment, implementation, and client reporting processes

Leadership & Culture:

• Build and sustain a high-performing, client-centric team grounded in The Humana Way
• Set clear goals, decision rights, performance expectations, and accountability measures
• Coach leaders and associates, address performance gaps, recognize strong contributions, and support succession readiness
• Foster cross-functional collaboration, inclusion, innovation, and continuous improvement
• The GM Director will meet monthly or more frequently with each assigned Sr. AE, AE and CEP to outline their expectations for each client within their book of business
• Set retention targets for each Sr. AE and AE and ensure retention targets and associated sales incentive payments are accurate

Use your skills to make an impact
 

Required Qualifications and Leadership Profile:

• Bachelor's degree in business, healthcare administration, or a related field; advanced degree preferred
• Extensive experience (typically 8+ years) in Medicare, managed care, health insurance, or regulated-industry experience, including 2-5+ years of people leadership
• Demonstrated expertise in client relationship management, regulatory compliance, and cross-functional collaboration
• Strong knowledge of client engagement, account management, renewals, service delivery, and financial or operational performance management
• Strong presentation and meeting facilitation skills
• Negotiation and conflict resolution skills
• Communication/customer service & collaborating skills are crucial since serving/interacting with numerous internal HUM client areas
• Ability to influence senior leaders and cross-functional partners, communicate complex information clearly, and translate strategy into executable plans
• Track record of developing talent, leading change, improving retention and experience, and building scalable operating practices
• Working knowledge of AI-enabled tools, automation, data governance, and responsible adoption in business workflows preferred
• Ability to travel – 50% or more
• Life and health license

Additional Information:

Success Measures

• Client and membership retention
• Client and Member NPS improvement
• Renewal quality, timeliness, and margin performance
• At-risk account stabilization and service performance
• Administrative efficiency, AI adoption, and productivity improvement
• Employee engagement, talent development, and team effectiveness

Work at Home Requirements: 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.

 

Scheduled Weekly Hours

40

Pay Range

The range below reflects a good faith estimate of total compensation for full time (40 hours per week) employment at the time of posting. This compensation package includes both base pay and targeted commission pay. The pay range may be higher or lower based on geographic location. Actual earnings will vary based on individual performance, with the base salary and commission structure aligned with company policies and applicable pay transparency requirements.

 

$124,100 - $294,300 per year

 

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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 10-09-2026
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.