Remote Enterprise Provider Network Transition Strategist

Humana Inc; Columbus (OH); Remote; USD 139,000 - 191,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

401(k) plan

Paid time off

Job summary

Humana Inc. is seeking a Principal, Provider Network Transition Strategy to lead enterprise initiatives around provider network changes. You will collaborate with contracting, operations, compliance and executive teams to assess impacts and drive readiness for big transitions.

The role requires deep provider network expertise, executive presence, and the ability to influence outcomes across a matrixed organization without direct ownership of execution teams. Remote with travel up to 10%.

Qualifications

• 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.
• Demonstrated experience leading large-scale, cross-functional initiatives across multiple business areas.
• Experience influencing leaders and driving results in a matrixed environment without direct authority.
• Experience utilizing data and analytics to drive business decisions and executive 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.

Responsibilities

• Lead Humana's enterprise strategy for provider network transition and disruption management initiatives, including assessment of member, provider, operational, regulatory, and business impacts.
• Serve as the enterprise lead for provider termination and provider network transition programs, ensuring cross-functional alignment and organizational readiness.
• Partner with Provider Contracting, Market Leadership, Member Retention, Stars, Provider and Member Service, Compliance, Provider Network Operations, and other key stakeholders to develop and implement mitigation strategies.
• Proactively identify emerging provider network risks and opportunities, developing recommendations for senior leadership regarding readiness, response, and enterprise prioritization.
• Drive initiatives that improve provider and member experiences during periods of provider network change while reducing operational friction and execution risk.
• Facilitate executive governance and decision-making processes related to provider network transitions and enterprise risk mitigation.
• Develop and maintain enterprise visibility into significant provider network events through reporting, analytics, executive communications, and performance monitoring.

Skills

Provider contracting

Provider network management

Healthcare operations

Strategy development

Cross-functional leadership

Executive communication

Travel readiness

Education

Bachelor's degree

Job description

Humana Inc. is seeking a Principal, Provider Network Transition Strategy to lead enterprise initiatives around provider network changes. You will collaborate with contracting, operations, compliance and executive teams to assess impacts and drive readiness for big transitions.

The role requires deep provider network expertise, executive presence, and the ability to influence outcomes across a matrixed organization without direct ownership of execution teams. Remote with travel up to 10%.