Becker’s Healthcare Podcast Driving Value and Innovation in Health Plan Operations with Gretchen Wagner
Mar 26, 2026
Gretchen Wagner, Associate Vice President of Risk Management at Humana, leads SNP governance and clinical operations. She talks about the shift from transactional care to value-based partnerships. She explores turning strategy into day-to-day operations, the need for coordinated digital adoption, and why analytics and interoperability are critical for efficiency and better member experiences.
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Career Path From Audit To Clinical Risk
- Gretchen moved from education into internal audit which gave her broad exposure across a company and led her into clinical roles at Humana.
- She now leads SNP governance, supports integrated DSNPs, and partners with clinical operations after 14+ years at Humana.
Value Based Models Replace Transactional Relationships
- Payer-provider relationships are shifting from transactional fee-for-service to collaborative value-based models focused on outcomes.
- Humana uses value-based contracts to align incentives, reduce hospitalizations, and reward coordination and personalized care.
Strategy Fails If Frontline Teams Are Left Out
- The biggest gap is translating long-term strategy into day-to-day frontline operations amid rapid technological change.
- Cross-functional implementation with feedback loops from providers, members, and frontline associates is key to close that gap.