VP, Medicaid Regional President, IN at Humana

Indianapolis, Indiana, United States

Humana Logo
Not SpecifiedCompensation
Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
Healthcare, Insurance, MedicaidIndustries

Requirements

  • Bachelor’s degree in business, Healthcare Administration, Public Health or related field
  • Experience in Medicaid MCO plan operation with demonstrated experience in TANF/CHIP/ABD/LTSS Waiver
  • Experience with budgeting and financial management of a health plan
  • Six (6) to ten (10) years of experience working in healthcare or government leadership and/or operations management
  • Leadership background with more than five (5) direct reports
  • Must reside or be willing to relocate to Indianapolis, IN
  • Preferred Qualifications
  • Master’s degree in business, Healthcare, Public Health, or related field
  • Experience in Medicaid MCO plan operations; experience in strategic and thought leadership in supporting Medicaid health plans; experience with budgeting and financial management of a health plan
  • DSNP Experience inclusive of Medicare Advantage
  • Proven track record of collaborating with Medicare teams to drive growth and optimize member outcomes for DSNP populations

Responsibilities

  • Manage executive Medicaid leadership team in the Indiana market, through which all plan associates report
  • Develop strategies, formulate policies, and oversee operations to ensure the appropriate objectives and goals are met
  • Represent Humana to the public, to plan members, to associates, to the state, and to subcontractors
  • Drive a focus on the delivery of high-quality care and support
  • Develop clear and measurable plan objectives, goals, and ideas
  • Establish and maintain a diverse, inclusive, and respectful environment
  • Promote a culture of health and well-being throughout the organization
  • Ensure plan compliance with federal and state laws and programmatic requirements, including fraud, waste, and abuse; make decisions in an ethical manner
  • Oversee operational policies and procedures
  • Ensure long-term health plan financial success, sustainability, and growth
  • Develop and adhere to budgets
  • Resolve urgent and emergency matters in a fair way according to applicable policies and procedures
  • Work with Humana National support teams to infuse best practices from other states and drive new ideas and initiatives from across the Medicaid and healthcare industry
  • Effectively support the growth of associates to enhance plan leadership and career development

Skills

Medicaid
DSNP
Waiver Programs
Executive Leadership
Strategic Planning
Regulatory Compliance
Stakeholder Management
Health Plan Operations
Policy Development
Healthcare Strategy

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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