Company name
Humana Inc.
Location
Glen Allen, VA, United States
Employment Type
Full-Time
Industry
Manager, Executive, Clevel, Finance, 100k
Posted on
Jun 15, 2021
Profile
Description
The Regional VP will be accountable for the development of strategic provider relationships at the regional level for all product lines. This position will:
Develop provider networks that help advance Humana's strategy and goals toward improving the health of the communities we serve
Lead the transition of targeted membership and providers to engagement agreements
Work with potential joint ventures and other innovative partnership opportunities
Develop and lead efforts re: continuous improvement for unit cost strategy
Report directly to the Regional President
Responsibilities
Responsibilities
Strategic Provider Partner for all segments (Medicare, Commercial and Medicaid), accountable for developing and maintaining provider engagement and networks for a region.
Foster and develop highly engaged internal and external partnerships
Ensure adequate coverage of primary care, specialty and ancillary services for Humana to meet both regulatory and strategic needs
Prioritize and align strategy between different segments and functions
Develop and execute shared strategy with Sales Organization to grow market share with engaged providers
Partner with providers to achieve shared success
Develop strategy for providers to move along path to value and influence providers to explore emerging value-based arrangements
Oversee regional and provider-specific quality, financial and operational performance
Transition targeted membership to engagement agreement and reduce costs via negotiations with key providers and trend management
Incorporate provider feedback and practice perspective into strategy planning, development and operations; enhance the provider experience with Humana
Align regional and corporate goals and drive these goals into the provider practice leveraging clinical resources
Provide leadership to regional provider engagement, contracting, and operations teams. Ensure regional operations are in alignment with the company's strategic objectives
Leverage talent and resources and champion a collaborative and integrated work environment. Lead initiatives to enhance productivity, develop talent, and change leadership
Required Qualifications
Deep knowledge of healthcare products, specifically Medicare
Proven experience developing multi-product strategy for provider contracting and provider engagement activities for all lines of business
Proven history of leadership through collaboration, influence, and partnerships
Strategic, enterprise-wide and integrated thinking; fosters a collaborative culture among cross functional business partners to drive business result
Demonstrated experience leading large teams, setting vision and goals, aligning talent, developing teams and associates, leading change and leading positively
Demonstrated success driving results and executing strategy effectively; ability to partner across functions to create and deploy win/win strategies
Experience analyzing the financial viability of complex provider contracts
Comprehensive knowledge of health plan finance and the compensation arrangements between health plans and providers
Knowledge of risk arrangements and ability to influence these arrangements
Experience identifying and recruiting providers to ensure network alignment with planned sales process execution, orienting providers and managing relationships, and driving improvement in provider satisfaction via education, communication and streamlining claims resolution
Ability to travel approximately 20% of the time within the region
Bachelor's degree required, preferably in Business Administration, Finance, or Health Care Administration
Preferred Qualifications:
Master's degree
7 years of business leadership experience, with a minimum of 5 years in a multi-state managed care environment as the leader of a Medicare network development/provider relations function
Desire to develop and maintain best-in class performance through relationships, collaboration, and shared success
Scheduled Weekly Hours
40
Company info
Humana Inc.
Website : http://www.humana.com