Director Market Leadership - Hawaii

Profile

Description

This role is uniquely positioned to influence health care leaders and other stakeholders to think differently about health and wellness. Enthusiasm for improving the health care system and prior community leadership experience within health-related foundations, associations, and charitable entities is strongly desired.The successful candidate will possess broad managed care leadership experience and significant Medicare Advantage experience from the payer side. He/she will have current or recent experience in the market with a strong track record of building provider relationships and expanding business opportunities. Prior business “ownership” and operating experience within a health care provider entity will be advantageous to this role.A current perspective regarding Health Care Reform initiatives and their impact on payer/provider business models is required, as is the ability to effectively articulate a strategy or value proposition to professionals across the continuum of health care business entities.

Responsibilities


Establish and maintain an executive leadership presence in key metropolitan markets within the markets, developing business relationships with customers and decision-makers in provider and community settings.

Represent Humana as a progressive thought leader on Health Care Reform initiatives and our approach to improving our health care system. Drive and support initiatives to position Humana as a leader in helping people achieve lifelong well-being and align this objective with business strategies supporting product development, agent attraction, and provider engagement.

Work closely with the Regional President to develop membership and financial performance goals for multiple markets, assessing which specific strategies and tools will be most effective.

As a key contributor to business strategy, develop trust and credibility with cross-functional leadership teams. Collaborate with National Contracting, Medical Management, MarketPoint (Medicare sales distribution), Market Operations, Commercial Sales/Operations, and other core functions to develop and execute on strategies specific to defined markets.

Align with the Provider Development/Engagement team to foster strategic provider relationships, with sensitivity to potential joint venture, acquisition and/or other innovative partnership opportunities.

Create innovative partnership opportunities which increase shared reward opportunities with providers; develop tactics which integrate Humana’s health and well-being strategies and commitments into provider orientation and ongoing communication


Required Qualifications


Bachelor’s degree in related field

8 plus years successful business leadership experience in managed care insurance, finance, health and wellness, with 5 or more years as the executive leader of a business development, network development or provider relations function

Comprehensive knowledge of health plan finance and the compensation arrangements between health plans and providers, including the financial viability of complex provider contracts

Familiarity with/exposure to Medicare managed care experience is essential

Experience building and managing relationships with a wide variety of providers

Prior operational leadership experience in finance, health services, and/or medical management; ability to partner across functions to create and deploy win/win strategies

Competencies such as big-picture visualization, critical thinking and sequencing, (i.e., the ability to envision the product of complex business goals and work backwards to ensure all of the requisite steps and details are covered for successful achievement)


Preferred Qualifications


Master's degree in related field

Medicaid and Dual-Eligible experience is desired


Additional Information

Scheduled Weekly Hours

40

About Us

Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.

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