Role: East Region Medical Vice President (Transcend & PIPC)
Location:VA, TN, OR North or South Carolina
As a company whose primary focus is on the well-being of its members, Humana is dedicated to shifting perceptions of the health insurance industry. We believe our role goes beyond that of a payer to that of a “well-being partner” who will empower consumers to live a life that’s healthy, active and rewarding. Success in these efforts ensures our ability to deliver on promises to key stakeholders.
In alignment with this focus, we are launching a search focused on identifying a dynamic physician executive leader who will have oversight of our wholly owned clinics in a geographical area, and will direct the staff and programs of Humana’s Management Services Organization (MSO). The MSO is aligned with the core tenets of the Integrated Care Model, and designed to provide exceptional clinical, analytical, risk adjustment and related operational services to our owned and contracted physicians nationally.
Key Role Objectives:
Actively participate with Market medical leadership to determine and implement strategies that will maximize the market’s performance
Oversees the implementation of quality improvement efforts designed to improve clinical performance and maintain compliance with accreditation standards
Provide representation when needed for clinical disciplines on market and corporate trend committees to provide translation of business issues to clinical tactics
Serve as a physician liaison to network providers and support the development of provider network by offering clinical expertise to the network contracting teams
Help to provide corporate clinical representation within the Market and vice versa
Assume accountability for initiatives that are clinical in nature
Develop strong relationships with market leaders to achieve individual and market success
National podium presence presenting at large conferences Key Competencies:
Acts strategically: makes decisions and sets strategy based on the long-term vision, uses an enterprise wide perspective to translate strategies into actions, inspires others to embrace and advance the strategy, and creates a clear view of the future state.
Leads Positively: Leads by example to cultivate a climate of motivation, positive energy and meaning in work. Assesses, selects, recognizes, develops, and empowers diverse talent.
Collaborates: Engages others by gathering multiple views and being open to diverse perspectives, focusing on a shared purpose that puts Humana's overall success first.
Board Certified MD/DO with an ABMS approved specialty
Active, unrestricted license
MBA and/or other advanced degree preferred comprehensive knowledge of healthcare finance, including the compensation arrangements between health plans and providers, including plan funding, risk management and provider reimbursement
Experience in managed care contracting and reimbursement
Experience in consulting, business, or other fields giving the candidate a well-rounded background to understand business challenges in the industry
Ability to manage multiple projects and priorities effectively and to accept direction according to the market needs and priorities
Ability to rapidly build positive relationships with consumers, employers, and providers at all levels in the marketplace Role Desirables
Master’s Degree in Business Administration or a related field
The East Region Medical Vice President will report directly to the Chief Medical Officer for the Care Delivery Organization.
Humana is an organization with careers that change lives—including yours. As an innovator in the fast-paced industry of healthcare, we offer our associates careers that challenge, support and inspire them to use their passion for helping others and to lead their best lives. If you’re ready to help people achieve lifelong well-being, and be a part of an organization that is growing and poised to make an impact on the future of healthcare, Humana has the right opportunity for you.
Apply now, or join our Talent Network so you can stay informed and up to date on what’s happening at Humana.
Title: East Region Medical Vice President - Transcend & PIPC
Other Locations: US-South Carolina, US-TN-Knoxville, US-South Carolina-Greenville, US-Virginia, US-Virginia-Glen Allen, US-Virginia-Richmond, US-South Carolina-Anderson, US-North Carolina, US-Tennessee
Requisition ID: 176965