Regional VP of Provider Contracting

1 week ago


Metairie, United States Humana Full time

Regional Vice President (RVP) Provider ContractingHumana is seeking an accomplished healthcare leader for the position of Regional Vice President (RVP) Provider Contracting. The RVP will provide executive leadership to the Provider Contracting team that supports Humana's Medicare line of business in the Gulf South Region, which includes LA, MS, AL, TN and Southwest Virginia. 35% travel should be expected in this role.The ideal candidate must live in the Gulf South Region (LA, MS, AL, TN or Southwest Virginia) and have deep expertise with the provider community and contracting. He/she will have extensive business leadership experience, with several years in a managed care environment leading contracting for Medicare products. This person will also possess comprehensive knowledge of health plan finance and the compensation arrangements between health plans and providers, including plan funding, risk management and provider reimbursement.Required QualificationsBachelor's degree5 plus years leadership experience in the healthcare industryExperience leading the end-to-end contract negotiation process through closure for all types of providers (physicians, hospitals, post-acute care facilities) and delegated specialty services across Medicare, Medicaid and Employer Group segments.Knowledge of value-based risk arrangements and ability to influence these arrangements.Solid track record of hiring and developing talent and preparing associates for roles of broader and greater responsibilityThe ability to identify health service expenses and implement cost control mechanisms within contracts.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.Prior executive leadership experience in sales, finance, legal, health services, and/or medical management; demonstrated ability to partner across functions to create and deploy win/win strategies.Recognition as a thought leader in the area of healthcare trend mitigation.Ability to effectively navigate and manage through a matrixed organizational environment in a large (Fortune 250) company.Strong relationship management skills, to teach, tailor, and take control of opportunity definition and initiation with business partners.Excellent oral and written communications skills, including the polish, poise, and executive presence that will ensure effective interaction with audiences and positive representation of Humana in external forums.Must reside or be willing to relocate to Gulf South Region (LA, MS, AL, TN or Southwest Virginia)Preferred QualificationsMaster's or J.D. degreeRecord of success leading provider contracting and provider engagement activities for all lines of businessScheduled Weekly Hours 40Pay Range $203,400 - $279,800 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Humana Inc. (NYSE: HUM) is committed to putting health first for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.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. 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.



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