Regional VP in Chicago, IL

Humana Inc   •  

Chicago, IL 60601

Industry: Healthcare

  •  

Not Specified years

Posted 56 days ago

Description

The Regional VP manages the development, operations, and results of a health plan. The Regional VP requires a in-depth understanding of how organization capabilities interrelate across segments and/or enterprise-wide.Responsibilities

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 direct to the Regional President

Responsibilities


  • Strategic Provider Partner for all segments (Medicare, Commercial and Medicaid), accountable for developing and maintaining provider engagement and networks for a region. 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
  • 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
  • Maintain commercial parity pricing in key commercial markets
  • 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, including Medicare, Commercial and Medicaid.
  • Proven experience developing multi-product strategy for provider contracting and provider engagement activities for all lines of business
  • 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


Valid Through: 2019-11-12