Remote Strategic Lead, Provider Network Transitions

Humana Inc; Atlanta (GA); Remote; USD 139,000 - 191,000; Full time

Job summary

Humana Inc. is seeking a strategic Principal, Provider Network Transition Strategy to lead enterprise initiatives around provider network changes and disruption events.

This role requires partnering across contracting, operations, member experience, and executive leadership to assess risk, develop mitigation plans, and improve readiness across the organization. The role emphasizes deep provider network expertise, executive presence, and influence in a matrixed environment, with responsibility

Qualifications

• 7+ years of experience in provider contracting or related healthcare strategy roles.
• 3+ years of project, program, or people leadership experience.
• Strong understanding of provider network operations in Medicare Advantage and/or Medicaid.
• Demonstrated experience leading cross-functional initiatives across multiple business areas.
• Experience influencing leaders in a matrixed environment without direct authority.
• Experience using data and analytics to drive executive decisions.
• Proven ability to communicate effectively with senior leaders and executives.
• 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.
• Serve as the enterprise lead for provider termination and provider network transition programs.
• Partner with Provider Contracting, Market Leadership, Member Retention, Stars, Provider and Member Service, Compliance, and other key stakeholders to develop mitigation strategies.
• Proactively identify emerging provider network risks and opportunities for senior leadership.
• Drive initiatives that improve provider and member experiences during periods of provider network change.
• Facilitate executive governance and decision-making processes related to provider network transitions and risk mitigation.
• Develop and maintain enterprise visibility into significant provider network events through reporting and analytics.

Skills

Provider contracting

Provider network management

Healthcare operations

Healthcare consulting

Executive communication

Data analytics

Cross-functional leadership

Travel willingness

TZ awareness

Education

Bachelor's degree

Job description

Humana Inc. is seeking a strategic Principal, Provider Network Transition Strategy to lead enterprise initiatives around provider network changes and disruption events.

This role requires partnering across contracting, operations, member experience, and executive leadership to assess risk, develop mitigation plans, and improve readiness across the organization. The role emphasizes deep provider network expertise, executive presence, and influence in a matrixed environment, with responsibility