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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. Serving as the primary liaison between the organization and the Oncology UM vendor, the Program Lead brings deep expertise in clinical workflows, utilization management, and vendor operations. This role exercises independent judgment in managing complex clinical and operational issues, identifying risks, and implementing effective solutions with minimal supervision.

The Oncology Program Lead ensures adherence to evidence-based practices, regulatory standards, and organizational goals to improve patient outcomes and operational performance. Advises executives to develop functional strategies (often segment specific) on matters of significance.

Key Responsibilities:

Vendor Strategy & Performance Management

• Lead 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

• Drives 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

Travel may be up to 25%

Use your skills to make an impact
 

Required 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

• Experience reviewing oncology treatment plans

• 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

Role Desirables

• Master’s degree in Nursing, Healthcare Administration, Public Health, or related field

• Experience working with oncology UM vendors or specialty benefit management program

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 recommended; wireless, wired cable or DSL connection is suggested

• Satellite, cellular and microwave connection can be used only if approved by leadership

• Employees 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.

• 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

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.

Humana 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 [email protected] with instructions on how to add the information into your official application on Humana’s secure website.

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 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.

 

$115,200 - $158,400 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, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

Application Deadline: 08-03-2026

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.