[Remote] Regional VP, Provider Contracting at Humana

Florida, United States

Humana Logo
Not SpecifiedCompensation
Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries

Requirements

  • Bachelor's Degree
  • Extensive leadership experience in the healthcare industry
  • Proven track record of driving operational performance improvement
  • Proven experience developing multi-product strategy at the market level or higher
  • Excellent verbal and written communications skills
  • Experience 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 providers
  • Knowledge 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
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Responsibilities

  • Manages the development, operations, and results of a health plan
  • Establishes long-range goals, objectives, and plans
  • Monitors financial and operational performance
  • Coordinates activities of senior managers and their respective functions
  • Represents the health plan externally and to governmental/external agencies
  • Makes decisions related to intradepartmental coordination, development and implementation of strategic plans, and business outcomes
  • Develops and implements strategic plans for the scope of management that are aligned with the Segment or Business strategy

Skills

Key technologies and capabilities for this role

Healthcare LeadershipProvider ContractingContract NegotiationHealth Plan FinanceRisk ArrangementsStrategic PlanningOperational PerformanceTalent DevelopmentMulti-Product Strategy

Questions & Answers

Common questions about this position

What is the salary range for the Regional VP, Provider Contracting role?

The starting base pay range is $203,400 - $279,800 per year, which may vary based on geographic location, skills, knowledge, experience, education, and certifications. This position is also eligible for a bonus incentive plan based on company and/or individual performance.

Is this a remote position, and what's the travel requirement?

This is a remote position, but occasional travel to Humana's offices for training or meetings may be required.

What are the key required qualifications and skills for this role?

Required qualifications include a Bachelor's Degree, extensive leadership experience in healthcare, proven track record in operational performance improvement and multi-product strategy, excellent communication skills, experience leading end-to-end contract negotiations with all provider types, comprehensive knowledge of health plan finance and provider compensation, knowledge of risk arrangements, and a track record of hiring and developing talent.

What benefits does Humana offer?

Humana offers competitive benefits that support whole-person well-being, including medical benefits designed to encourage personal wellness and smart healthcare decisions for associates and their families.

What makes a strong candidate for this Regional VP role?

A strong candidate will have a Bachelor's Degree (Master's or J.D. preferred), extensive healthcare leadership experience, proven success in operational improvements, multi-product strategy, end-to-end provider contract negotiations, health plan finance, risk arrangements, and talent development, along with passion for improving consumer experiences.

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters
1961Year Founded
IPOCompany Stage
Social Impact, HealthcareIndustries
10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.
Rising medical costs and tightening Medicare reimbursements may strain financial performance.
Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.
The company emphasizes inclusivity, offering free language interpreter services for accessibility.
Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.
The company is the first insurer to cover TMS therapy for adolescent depression.
Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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