Regional VP Network Contracting Northeast Region

Remember to check your CV before applying Also, ensure you read through all the requirements related to this role.

Become a part of our caring community and help us put health first

Humana is seeking an accomplished healthcare leader for the position of Regional Vice President, Provider Experience and Contracting.

The Regional Vice President (RVP) will foster the development of strategic provider relationships for all product lines in Humana’s Northeast Region, which extends from Maine to New York.

This position will develop provider networks that help advance Humana’s strategy and goals toward improving the health of the communities we serve.

The RVP will also provide executive leadership to the Provider Contracting, Provider Education, and Provider Engagement in support of Humana’s Medicare lines of business.

In addition, the RVP will lead the transition of targeted membership and providers to engagement agreements, identify and work with potential joint ventures and other partners, and drive efforts for continuous improvement for unit cost strategy.

35% travel should be expected in this role.

This position reports to the Northeast Region President and must currently reside in one of the following states : ME, MA, NH, VT, RI, NY, NJ, CT, MD, DE, PA or DC.

Position has 7 direct reports and 40+ indirect reports.

The ideal candidate must live in the Northeast Region and have deep expertise with the provider community in the metro area.

He / she will have extensive business leadership experience, with several years in a managed care environment leading a network development / provider relations function, including proven experience leading contracting for Medicare products.

This person will also possess comprehensive knowledge of health plan finance and the compensation arrangements between health plans and providers, including plan funding, risk management, and provider reimbursement.

Use your skills to make an impact

Required Qualifications

• Bachelor’s degree
• 5 plus years leadership experience in the healthcare industry
• 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 across Medicare, Medicaid, and Employer Group segments.
• Knowledge of value-based 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.
• The ability to identify health service expenses and implement cost control mechanisms within contracts.
• 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.
• Prior executive leadership experience in sales, finance, legal, health services, and / or medical management; demonstrated ability to partner across functions to create and deploy win / win strategies.
• Recognition as a thought leader in the area of healthcare trend mitigation.
• Ability to effectively navigate and manage through a matrixed organizational environment in a large (Fortune 250) company.
• Strong relationship management skills, to teach, tailor, and take control of opportunity definition and initiation with business partners.
• Excellent oral and written communications skills, including the polish, poise, and executive presence that will ensure effective interaction with audiences and positive representation of Humana in external forums.
• Proven ability to overcome resistance from key stakeholders and to stand firm in the face of pushback.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

Preferred Qualifications

• Master's or J.D. degree
• Record of success leading provider contracting and provider engagement activities for all lines of business.

Scheduled Weekly Hours

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting.

The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job-related skills, knowledge, experience, education, certifications, etc.

$199,400 - $274,400 per year. This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and / or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, Humana ) offers competitive benefits that support whole-person well-being.

Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work.

Among our benefits, Humana provides medical, dental, and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance, and many other opportunities.

About us

Humana Inc. (NYSE : HUM) is committed to putting health first for our teammates, our customers, and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health delivering the care and service they need, when they need it.

These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or veteran status.

It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or protected veteran status, and to base all employment decisions only on valid job requirements.

This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay, or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

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