Regional VP Health Services Mid

1 month ago


Bethesda, Maryland, United States CLevelCrossing Full time

The Regional VP, Health Services will serve as the Senior Physician for the Mid-Atlantic region.The Regional VP, Health Services is a vital member of the Mid-Atlantic region senior leadership team, as well as the Humana clinical community.Provide medical leadership and strategy for the region's Health Services Operations (HSO), including fiscal responsibility for managing medical cost trends for the Mid-Atlantic region.Oversee regional utilization management for case types including but not limited to inpatient (acute care hospital, LTAC, Acute rehab, SNF), as well as according to the Humana Medicare Model of Care.Participate in regional or Humana national level committees, including meetings related to medical necessity determination processes and Medical Director audit processesAssist with network development and provider contracting with various providers and ancillary providers.A current and unrestricted physician license in at least one state or jurisdiction, and must have willingness to obtain additional licenses, if required, in states within the Humana Medicare Advantage management region.The weekly testing will need to be done through an approved Humana vendor, and unvaccinated associates should follow all social distancing and masking protocols if they are required to come into a Humana facility or work outside of their home.



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