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Company: Humana
Location: Miramar
Posted on: May 3, 2021

Job Description:



Humana, one of the nation's leading insurers of healthcare services, is aligned with its strategic physician partners through a variety of strategies including owned, joint ventured and contracted providers in the South Florida area. We are committed to delivering health care as it should be: patient-centered and for the good of all people, no matter their circumstance.

Under the direction of the Regional President, the Market VP of MSO Engagement and Performance is responsible for facilitating the alignment of managed care initiatives within our risk-partner community. This leader will communicate the vision for risk-partner alignment, influence internally and externally, and encourage understanding and participation with Humana managed care initiatives. The position requires understanding of the competitive landscape and identifying growth opportunities within our existing network and beyond.

By creating a new set of economic incentives, Humana is creating business models with our MSOs and IPAs that may result in changes in physician behavior (i.e. changes in the physician care process and referral patterns) that could affect local market share. Capitation, narrow networks, steerage, tiering and new products can all be expected to result from these models. Knowledge, understanding, and alignment of strategies will be necessary as these organizations have potential for volume growth.

The position serves as a key strategic leader for region-wide MSO initiatives, recommending methods for managing changes, communicating, and minimizing negative impact to MSO groups. In conjunction with Division/Market Leadership, this position is charged with the following responsibilities for Humana projects and initiatives, which include:

+ Identify MSO/risk-provider engagement needs and promote involvement at multiple levels

+ Provide executive leadership to the HEDIS/Quality, with responsibility for performance throughout the state of FL

+ Development of a Physician Organization Alignment plan including consideration for a Practice Center of Excellence initiative to support individual providers or underperforming MSOs

+ Coordinate closely with the Regional VP of Provider Engagement for Hospital Contracting, Large Practice and Ancillary Contracting, MSO Ops, and Clinical Operations in all markets

+ Collaborate with leadership team to develop strategy on alignment with physician organizations

+ Remain connected and informed about impending alignment activity, operational changes and new contracts with existing physician organization in market

+ Maintain contemporary tools, resources and capabilities

+ Maintain leadership level reporting on physician alignment activity and opportunities

+ Ability to travel 30-50%, primarily in and around South Florida

**Required Qualifications**

+ Bachelor's degree in Business Administration or Healthcare Administration

+ Extensive experience 10 years required - Prefer 15 years in managed care, provider contracting & clinical/provider engagement, preferably with in South Florida

+ 5 or more years of people and project leadership experience

+ Proven track record of success in creating and executing operational and managed care growth strategies for multiple entities

+ Must have held leadership positions (reflecting increasing levels of responsibility) in roles where developing and influencing a strategic vision and relationship building was a key responsibility Participative management style and an ability to work in a matrix environment

+ Extensive experience leading and mentoring leaders to ensure goals and initiatives are met, and teams are engaged and productive

+ Excellent interpersonal skills with an ability to work effectively with diverse groups of people, including but not limited to Corporate/Division leadership, staff from finance, information technology and clinical backgrounds, physicians, and external vendors

+ Must be independent, driven, self-motivated, and passionate with an exceptional work ethic, executive presence, integrity and presentation skills, both oral and written

+ Demonstrated leadership competency in customer needs and expectations, human resource management, financial outcomes, strategic vision and execution, marketing initiatives, and continuous improvement skills

+ Ability to work well under pressure on concurrent, multidisciplinary projects

+ Excellent attention to detail and creative problem solving abilities

+ Expert knowledge of various external market forces affecting Humana

+ Ability to establish credibility and be decisive

+ High level of strategic acumen, with strong analytical skills and ability to solve problems in a timely basis

+ Must be passionate about contributing to an organization focused on continuously improving consumer experiences

**Preferred Qualifications**

+ Master's or Doctorate degree

+ Project Management experience

+ Bilingual English/Spanish

**Scheduled Weekly Hours**


Keywords: Humana, Hollywood , VP, Other , Miramar, Florida

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