Humana East Region Medical Vice President - Transcend & PIPC in North Carolina

Role: East Region Medical Vice President (Transcend & PIPC)

Location:VA, TN, OR North or South Carolina

Assignment Capsule:

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.

    • Role Essentials: *
  • 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

  • Private practice experience
  • Board certification

    Reporting Relationships

    The East Region Medical Vice President will report directly to the Chief Medical Officer for the Care Delivery Organization.

    Additional Information

    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

Location: Virginia-Richmond

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