Principal – Provider Network Transition Strategy

Job not on LinkedIn

🔥 0 minutes ago

🇺🇸 United States – Remote

💵 $138.9k - $191k / year

⏰ Full Time

🔴 Lead

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Lead Humana's enterprise strategy for provider network transition and disruption management initiatives • Assess member, provider, operational, regulatory, and business impacts of provider network changes • Serve as enterprise lead for provider termination and provider network transition programs • Partner with Provider Contracting, Market Leadership, Member Retention, Stars, Provider and Member Service, Compliance, Provider Network Operations, and other stakeholders • Develop and implement mitigation strategies • Identify emerging provider network risks and opportunities and recommend actions to senior leadership • Improve provider and member experiences while reducing operational friction and execution risk • Facilitate executive governance and decision-making for provider network transitions and enterprise risk mitigation • Develop reporting, analytics, executive communications, and performance monitoring for significant provider network events • Evaluate impacts on member retention, access to care, network adequacy, Stars performance, service operations, and overall business performance • Lead cross-functional process simplification and coordination efforts • Influence leaders across a matrixed organization to drive accountability and remove barriers without direct operational ownership • Advise senior leaders and executives on strategic initiatives, organizational risks, and opportunities • Identify and prioritize opportunities to strengthen Humana's provider network transition capabilities

🎯 Requirements

• 7+ years of experience in provider contracting, provider network management, healthcare operations, healthcare consulting, or related healthcare strategy roles • 3+ years of project, program, or people leadership experience • Strong understanding of provider network operations, provider contracting strategy, healthcare delivery systems, and payer-provider relationships in a Medicare Advantage and/or Medicaid environment • Experience leading large-scale, cross-functional initiatives across multiple business areas • Experience influencing leaders and driving results in a matrixed environment without direct authority over execution teams • Experience using data and analytics for business decisions and executive-level recommendations • Proven ability to communicate effectively with senior leaders and executive stakeholders • Ability and willingness to travel up to 10% • Must reside within the Central or Eastern Time Zone • Preferred: Bachelor's degree • Experience navigating complex regulatory, operational, and member experience considerations within a health plan environment • Minimum home internet speed of 25 Mbps download and 10 Mbps upload • Ability to work from a dedicated space without ongoing interruptions to protect member PHI/HIPAA information

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Remote/work-at-home arrangement • Internet service requirements and dedicated workspace support for home working • Training and meeting travel support as applicable