RVP Network Contracting - SE Region

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🇺🇸 United States – Remote

🌲 North Carolina – Remote

Although this job is listed in North Carolina, this company may be open to hiring remote in other states.

⚔️ Virginia – Remote

Although this job is listed in Virginia, this company may be open to hiring remote in other states.

💵 $203.4k - $279.8k / year

⏰ Full Time

🔴 Lead

👔 Vice President

🦅 H1B Visa Sponsor

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

⚕️ Healthcare Insurance

Description

• 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, Contracting. • The RVP will foster the development of strategic provider relationships for all product lines in Humana’s Southeast Region, with direct accountability for Virginia and North Carolina. • 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, 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 Southeast Region President and must reside in one of the following states: VA or NC. • Relocation will be considered for the ideal candidate. • Position has 7 direct reports and ~ 40+ indirect reports. • This leaders sits on the Southeast Region leadership team and is expected to meaningfully contribute to decisions across all aspects of the region. • Understanding of bids, medical costs, local dynamics and enterprise strategy is a must. • This role will lead the building of the Medicaid Network in Virginia in anticipation of future Humana Medicaid offering in the state. • The ideal candidate must live in the VA or NC 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.

Requirements

• 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 • Must be passionate about contributing to an organization focused on continuously improving consumer experiences. • 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 overcome resistance from key stakeholders and to stand firm in the face of pushback.

Benefits

• Health benefits effective day 1 • Paid time off, holidays, volunteer time and jury duty pay • Recognition pay • 401(k) retirement savings plan with employer match • Tuition assistance • Scholarships for eligible dependents • Parental and caregiver leave • Employee charity matching program • Network Resource Groups (NRGs) • Career development opportunities