Strategic Leader, Provider Network Transitions

Humana Inc; San Juan (PR); Remote; USD 139,000 - 191,000; Full time

Job summary

Humana Inc. is seeking a Principal, Provider Network Transition Strategy to lead enterprise-level initiatives shaping provider network transitions and disruption management. This role partners across contracting, operations, and executive leadership to assess risks, develop mitigation, and improve readiness.

The position emphasizes deep provider network expertise, executive presence, and influencing outcomes in a matrixed environment. Remote work is available with ETZ residency.

Qualifications

• 7+ years of experience in provider contracting, provider network management, healthcare operations, or related healthcare strategy roles.
• 3+ years of project, program, or people leadership experience.
• Experience influencing leaders in a matrixed environment without direct authority.
• Must reside in the Central or Eastern Time Zone.
• Willingness to travel up to 10%.

Responsibilities

• Lead Humana's enterprise strategy for provider network transition and disruption management.
• Serve as enterprise lead for provider termination and provider network transition programs.
• 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.
• Utilize data and business insights to evaluate downstream impacts of provider network changes on member retention, access to care, network adequacy, Stars performance, service operations, and overall business performance.
• Lead cross-functional efforts to simplify processes, improve coordination across teams, and strengthen enterprise capabilities related to provider network transitions.
• Influence leaders and stakeholders across a matrixed organization to drive accountability, remove barriers, and achieve desired business outcomes without direct operational ownership.
• Advise senior leaders and executives on strategic initiatives, organizational risks, and opportunities related to provider network change management.
• Identify and prioritize future opportunities that enhance Humana's ability to effectively manage provider network transitions and disruption events.

Skills

Provider contracting

Provider network management

Healthcare operations

Healthcare consulting

Cross-functional leadership

Data analytics

Executive communication

Travel willingness

Education

Bachelor's degree

Job description

Humana Inc. is seeking a Principal, Provider Network Transition Strategy to lead enterprise-level initiatives shaping provider network transitions and disruption management. This role partners across contracting, operations, and executive leadership to assess risks, develop mitigation, and improve readiness.

The position emphasizes deep provider network expertise, executive presence, and influencing outcomes in a matrixed environment. Remote work is available with ETZ residency.