Remote Strategic Lead – Provider Network Transitions

Humana Inc; Carson City (NV); Remote; USD 139,000 - 191,000; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

Humana Inc. seeks a Principal, Provider Network Transition Strategy to lead enterprise-wide initiatives affecting member access, provider experience, and business performance.

You will partner across Contracting, Market Operations, Stars, and executive teams to assess risk and set readiness strategies for provider network changes. You will influence decision-making and drive mitigation efforts without direct ownership of execution teams, navigating a highly matrixed environment while ensuring

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 that require collaboration across multiple business areas.
• Experience influencing leaders and driving results in a matrixed environment without direct authority over execution teams.
• Experience utilizing data and analytics to drive business decisions and executive-level 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.
• Serve as the enterprise lead for provider termination and provider network transition programs.
• Partner with key stakeholders to develop and implement mitigation strategies.
• Identify emerging provider network risks and opportunities for senior leadership.
• Drive initiatives that improve provider and member experiences during provider network change.
• Facilitate executive governance and decision-making processes.
• Develop and maintain enterprise visibility into provider network events with reporting and analytics.
• Utilize data to evaluate impacts on member access, network adequacy, and business performance.
• Lead cross-functional efforts to improve coordination and enterprise capabilities.
• Influence leaders to drive accountability without direct execution ownership.
• Advise senior leaders on strategic initiatives and risks related to provider network change.
• Identify and prioritize future opportunities to manage transitions effectively.

Skills

Provider contracting

Provider network management

Healthcare operations

Healthcare consulting

Strategic program leadership

Cross-functional collaboration

Executive communication

Travel up to 10%

Time zone flexibility

Education

Bachelor's degree

Job description

Humana Inc. seeks a Principal, Provider Network Transition Strategy to lead enterprise-wide initiatives affecting member access, provider experience, and business performance.

You will partner across Contracting, Market Operations, Stars, and executive teams to assess risk and set readiness strategies for provider network changes. You will influence decision-making and drive mitigation efforts without direct ownership of execution teams, navigating a highly matrixed environment while ensuring