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Regional VP Provider Contracting
4 weeks ago
Regional Vice President, Provider ContractingBecome a part of our caring community and help us put health first. Humana is a Fortune 50 market leader in integrated healthcare delivery. As a company whose primary focus is on the well-being of its members, Humana is dedicated to shifting perceptions of the health insurance industry. We believe our role goes beyond that of an insurer to that of a well-being partner. Through product and service offerings anchored in a whole person view of human well-being, Humana embraces a focus on stimulating positive individual and population changes while nurturing a sense of security, enabling people to live life fully and be their most productive. Against that backdrop, Humana is seeking an accomplished healthcare leader for the position of Regional Vice President, Provider Contracting. The Regional Vice President will foster the development of strategic provider relationships for all product lines in the Central Region, encompassing KS, MO, IA, NE, IL, WI, MN, ND and SD. This position will develop provider networks that help advance Humana's strategy and goals toward improving the health of the communities we serve. The Regional Vice President will also provide executive leadership to Provider Contracting, Provider Education and Provider Engagement in support of Humana's Group, Medicare, and Medicaid lines of business. This position reports to the Central Region President and will need to reside within the Region. 20% travel within the region can be expected.Key Responsibilities:Strategic Partner with all segments (Medicare, Group and Medicaid) accountable for developing and maintaining strategic network relationships with regional providers. Ensure adequate coverage of primary care, specialty and ancillary services for Humana to meet both regulatory and sales support need.Align strategy and priority between different segments/functions and be the defined point of contact for escalated provider engagements and issues.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.Ensure access to care for members, network adequacy and gap closure.Participate with Medicare and Medicaid trend initiatives with key providers and partners.Executive leadership of Provider Performance and Analytics functions, supporting Humana's value-based contracts and trend bender initiatives.Collaborate with internal partners to ensure best in class credentialing, contract load and directory accuracy.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.Use your skills to make an impactRequired Qualifications:Bachelor's degree/Master's preferred7 plus years leadership experience in the healthcare industry5 plus years 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.Comprehensive knowledge of health plan finance and the compensation arrangements between health plans and providersKnowledge of 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 responsibility.The 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.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.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.Scheduled Weekly Hours 40Pay 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. $203,400 - $279,800 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, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.About Us: 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, 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. Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services.
