RVP Network Contracting- SE Region (VA/NC)

Posted 2 Days Ago
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Home Acres, NC
203K-280K Annually
Senior level
Healthtech
The Role
The Regional Vice President, Contracting will develop strategic provider relationships and networks in the Southeast Region for Humana, focusing on improving community health. Responsibilities include leading provider contract negotiations, managing a team, and ensuring compliance with healthcare regulations. Expect 35% travel.
Summary Generated by Built In

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 Regional Vice President (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 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.​


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
  • 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.

Preferred Qualifications

  • Master's or J.D. degree

Additional Information

  • Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from [email protected] with instructions on how to add the information into your official application on Humana’s secure website.
  • Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:
  • 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

Scheduled Weekly Hours

40

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.


 

$203,400 - $279,800 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.

The Company
Chicago, IL
40,741 Employees
On-site Workplace
Year Founded: 1961

What We Do

At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.

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