Job added in hotlist
Applied job
Contract job
90-day-old-job
part-time-job
Recruiter job
Employer job
Expanded search
Apply online not available
View more jobs in Phoenix, AZ
View more jobs in Arizona

Job Details

Director Group Provider Strategy - North

Company name
Humana Inc.

Location
Phoenix, AZ, United States

Employment Type
Full-Time

Industry
Executive, Manager

Posted on
Aug 13, 2021

Apply for this job






Profile

Description

The Director, Group Provider Strategy partners with the assigned Employer Group Market Presidents within the Region on the Employer Group provider strategy, provider performance and health plan contract compliance. The Director, Group Provider Strategy requires an in-depth understanding of how organization capabilities interrelate across the segment and enterprise.

Responsibilities

Contracting expert for aligned Employer Group markets.

Partners with Market Presidents, RVPs, Provider Experience and the centralized provider organizations to improve growth and profitability within the assigned markets.

Lead and advance market strategies that will drive parity improvements, unit cost improvements, deliver medical trend bender savings, and maintain and drive new network innovations to remain contemporary with the industry and competitive in the local markets.

Create and execute on break-through plans in focus markets and disruption plans in non-focus markets.

Create and implement initiatives to increase membership in value-based contracts to improve quality, outcomes and cost-of-care.

Increase member steerage to higher performing providers to support upmarket growth.

Develops and implements programs and large-scale provider initiatives for the aligned markets, such as transparency initiatives, brand- over networks, network adequacy etc.

Works closely with RVPs, Provider Experience and RVP, Group Market Operations to identify target markets where Humana can win in Commercial.

Partners with contracting team to communicate contract terms, payment structures, and reimbursement rates to providers. Ensure the Employer Group's needs are met during negotiations.

Analyzes financial impact of Provider contracts and terms. Ensures that commercial plans are meeting or exceeding corporate Commercial performance benchmarks.

Builds and maintains relationships, and represents the Employer Group priorities with aligned RVPs, Provider Engagement, Retail Market Presidents and centralized provider functions.

Build and maintains relationships with providers and aligned partners within a region. Participates in provider Joint Operating Committees and represents the EG Market President as needed.

Partners with Provider Engagement Executives aligned to key provider and IDSes. Delivers and consult with aligned providers on Group provider performance and quality data.

Required Qualifications

At least 5 years of relevant industry experience with commercial health plans and experience leading or influencing others.

Prior demonstrated success in network management or provider engagement/relations.

Proven experience working with Market Leaders and senior leaders within Humana.

Understanding of corporate strategic goals; Understanding of Humana's clinical model.

Excellent written and verbal communications skills.

Experience in creating, and executing on, an enterprise scale business development strategic plan

Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Expert collaborator

Bachelor's degree

Preferred Qualifications

Master's degree

Additional Information

Work location is flexible

#MarketOpModel

Scheduled Weekly Hours

40

Company info

Humana Inc.
Website : http://www.humana.com

Similar Jobs:
Description As Humana's Medicaid membership continues to grow, the National Medicaid Clinical Operations team is expanding our shared services organization to enhance the clinical delivery process. The National Medicaid Director ...
Description We're looking for someone who is well rounded in the end-to-end journey of Medical Insurance to lead our Provider Systems team supporting Provider Operations across the enterprise. You will be a critical part in not o...
AVP Enterprise Architecture Practices
Location : Phoenix, AZ
Description The Associate VP, Enterprise Architecture translates business needs into technical systems solutions and architectural roadmaps. The Associate VP, Enterprise Architecture requires a in-depth understanding of how organ...
I like the volume of jobs on EmploymentCrossing. The quality of jobs is also good. Plus, they get refreshed very often. Great work!
Roberto D - Seattle, WA
  • All we do is research jobs.
  • Our team of researchers, programmers, and analysts find you jobs from over 1,000 career pages and other sources
  • Our members get more interviews and jobs than people who use "public job boards"
Shoot for the moon. Even if you miss it, you will land among the stars.
ExecCrossing - #1 Job Aggregation and Private Job-Opening Research Service — The Most Quality Jobs Anywhere
ExecCrossing is the first job consolidation service in the employment industry to seek to include every job that exists in the world.
Copyright © 2024 ExecCrossing - All rights reserved. 21 192