[Hiring] Principal, Provider Network Transition Strategy @Humana

Role Description

The Principal, Provider Network Transition Strategy serves as an enterprise leader responsible for developing and advancing Humana's strategy for significant provider network changes and disruption events. This highly visible individual contributor role partners across various teams to assess risk, develop mitigation strategies, and improve organizational readiness related to provider network transitions.

• Leads complex, enterprise-wide initiatives that influence member access, provider experience, business performance, and operational outcomes.
• Works across organizational boundaries to identify risks, improve business processes, and build a Provider Network Transitions Program.
• Partners closely with senior leaders to evaluate operational, regulatory, financial, and member impacts.
• Drives enterprise alignment, facilitates decision-making, and influences outcomes through partnership with leaders across multiple business functions.
• Serves as the enterprise lead for provider termination and provider network transition programs.
• Proactively identifies emerging provider network risks and opportunities.
• Drives initiatives that improve provider and member experiences during periods of provider network change.
• Facilitates executive governance and decision-making processes related to provider network transitions.
• Develops and maintains enterprise visibility into significant provider network events.
• Utilizes data and business insights to evaluate downstream impacts of provider network changes.
• Leads cross-functional efforts to simplify processes and strengthen enterprise capabilities.
• Advises senior leaders and executives on strategic initiatives and organizational risks.
• Identifies and prioritizes future opportunities that enhance Humana's ability to manage provider network transitions.

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.
• Experience influencing leaders and driving results in a matrixed environment.
• Experience utilizing data and analytics to drive business decisions.
• 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.

Requirements

• Bachelor's degree (preferred).
• Experience navigating complex regulatory, operational, and member experience considerations within a health plan environment.

Benefits

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Time off (including paid time off, company and personal holidays, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life insurance and many other opportunities.

Company Description

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health.