Regional VP, Health Services

🕒 Outubro 5

🇺🇸 Estados Unidos – Remoto (EUA)

💵 $327.700 - $450.600 / ano

⏰ Tempo Integral

🔴 Especialista

👔 Vice-presidente

🦅 Patrocina Visto H1B

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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Logo of Humana

Humana

10.000+ funcionários

Fundada em 1961

🏥 Saúde

🛡️ Seguros

⚕️ Seguro de Saúde

Healthcare • Insurance • Healthcare Insurance

A Humana é uma empresa de saúde dedicada a gerar um impacto positivo na saúde de indivíduos, comunidades e do sistema de saúde como um todo. Com foco em colocar a saúde em primeiro lugar, a Humana atende a uma ampla e diversa gama de populações, incluindo idosos e militares, oferecendo planos Medicare Advantage (HMO, PPO e PFFS). A Humana está comprometida em promover uma cultura de pertencimento e respeito mútuo, oferecendo benefícios competitivos e flexíveis para garantir a segurança financeira de seus funcionários e de suas famílias. A empresa se orgulha de criar um ambiente de trabalho inclusivo, no qual todos têm a oportunidade de ter sucesso.

Descrição

• Provide market-based medical leadership and clinical strategy for Humana Healthy Horizons in Indiana • Oversee clinical operations, quality, utilization management, population health, and medical cost strategy • Serve as senior clinical representative to the State, providers, community partners, and other stakeholders • Provide strategic and operational clinical leadership for Indiana Medicaid lines of business, including Medicaid-only, Medicaid LTSS, integrated Medicare-Medicaid products, and integrated D-SNP • Support Medicaid business development, procurement strategy, stakeholder engagement, competitive market positioning, provider partnership opportunities, and innovative clinical solutions • Provide medical leadership and strategy for Health Services Operations with fiscal responsibility for trend management • Collaborate across internal and external stakeholders in a highly matrixed environment • Oversee utilization management, care management, quality operations, and medical necessity strategies • Lead clinical strategy, performance, compliance, and operational effectiveness of care management programs • Lead market-level clinical programs and quality improvement initiatives, including HEDIS/STARS performance, peer review activities, and Quality Management Committee governance • Partner with providers, facilities, and ancillary networks to strengthen relationships, support contracting activities, and drive value-based and risk-sharing arrangements

🎯 Requisitos

• M.D. or D.O. degree • Current, unrestricted medical license and board certification • Ability to practice in Indiana • 10+ years of progressive clinical and healthcare leadership experience • Experience in managed care, Medicaid, Medicare, or value-based care environments • Proven experience leading utilization management, care management, quality improvement, population health, and medical cost management strategies • Ability to influence executive leaders, state partners, and cross-functional teams • Experience partnering with providers, health systems, community organizations, and government stakeholders • Strong strategic, financial, and executive leadership skills • Experience working directly with state Medicaid agencies, CMS, accreditation organizations, and regulatory oversight entities • Minimum home internet speed of 25 Mbps download and 10 Mbps upload • Preferred: senior clinical leadership experience in Medicaid managed care, integrated care, MLTSS, D-SNP, FIDE-SNP, or other Medicare-Medicaid integrated models • Preferred: medical management experience with health insurance organizations, hospitals, healthcare providers, and patient interaction • Preferred: Internal Medicine, Family Practice, Geriatrics, Hospitalist, ER, PM&R clinical specialization • Preferred: Master's Degree

🏖️ Benefícios

• Bonus incentive plan based on company and/or individual performance • Medical, dental, and vision benefits • 401(k) retirement savings plan • Paid time off • Company and personal holidays • Paid parental and caregiver leave • Short-term and long-term disability • Life insurance • Dedicated work-from-home space • Remote work arrangement • Occasional travel to Humana offices for training or meetings

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