VP, National Provider Network Management
Humana
full-time
Posted on:
Location Type: Hybrid
Location: Louisville • Illinois • Kentucky • United States
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Job Level
About the role
- Develop and lead national provider network strategy across Medicare and Medicaid segments
- Strategic Partner with all segments of Humana's Insurance Business
- Ensure adequate coverage of primary care, specialty and ancillary services
- Align strategy and priority between different segments/functions
- Establish enterprise wide contracting standards, best practices and policies for Medicare and Medicaid lines of business
- Lead Enterprise change efforts regarding contract standardization
- Ensure access to care for members, network adequacy and gap closure
- Develop and lead trend initiatives with key providers and partners
- Executive leadership of Provider Performance and Analytics functions
Requirements
- Bachelor's degree
- 10 plus years contracting and/or managing relationships with Integrated Delivery Systems
- 6 plus years business leadership experience, with several years in a managed care environment leading a network development/provider relations function
- Experience leading the 'end-to-end' contract negotiation process through closure for different types of providers
- Proven skill in driving results, thinking strategically and executing strategy effectively
- Knowledge of risk arrangements and ability to influence these arrangements
- Record of success leading the delivery of large, enterprise-scale initiatives involving multiple functions and business segments
- Strong relationship management skills
- Comprehensive knowledge of health plan finance and the compensation arrangements between health plans and providers
Benefits
- Health insurance
- 401(k) matching
- Professional development opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
contract negotiationprovider relationsnetwork developmentrisk arrangementshealth plan financeenterprise-scale initiativescontracting standardsbest practicesanalyticstrend initiatives
Soft Skills
strategic thinkingrelationship managementexecutive leadershipdriving resultsinfluencingcommunicationcollaborationorganizational skillschange managementproblem-solving
Certifications
Bachelor's degree