Regional VP- Mid-Atlantic Region

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