VP, Medicaid Regional President, IN at Humana

Indianapolis, Indiana, United States

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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

Key technologies and capabilities for this role

MedicaidDSNPWaiver ProgramsExecutive LeadershipStrategic PlanningRegulatory ComplianceStakeholder ManagementHealth Plan OperationsPolicy DevelopmentHealthcare Strategy

Questions & Answers

Common questions about this position

What is the location requirement for this role?

The position requires being based in Indiana and serving as the primary point of contact for the state, with candidates required to reside or be willing to relocate to Indianapolis, IN.

What are the required qualifications for this position?

Candidates need a Bachelor’s degree in business, Healthcare Administration, Public Health or related field, experience in Medicaid MCO plan operation including TANF/CHIP/ABD/LTSS Waiver, experience with budgeting and financial management of a health plan, and 6-10 years in healthcare or government leadership and/or operations management.

What is the salary or compensation for this role?

This information is not specified in the job description.

What kind of company culture does this role promote?

The role involves establishing and maintaining a diverse, inclusive, and respectful environment while promoting a culture of health and well-being throughout the organization.

What makes a strong candidate for this VP position?

Strong candidates will have demonstrated experience in Medicaid MCO operations, financial management of health plans, and 6-10 years in healthcare or government leadership, along with the ability to lead executive teams and drive strategic growth.

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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