Market VP of MSO Engagement and Performance

Profile

Description

Responsibilities

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

40

Company info

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