Humana logo
Humana

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it.

Regional VP, Health Services

Vice PresidentVice PresidentOtherRemoteLeadTeam 10,001+Since 1961H1B SponsorCompany SiteLinkedIn

Location

Ohio

Posted

3 days ago

Salary

$327.7K - $450.6K / year

Seniority

Lead

Postgraduate Degree8 yrs expEnglish

Job Description

• Oversee regional utilization management and case management for inpatient cases according to the Humana Medicare Model of Care • Participate in Quality Operations including chair Quality Management Committee • Oversee administrative budget for regional HSO & Quality Improvement • Oversee Quality Improvement and HEDIS/STARS metrics improvement with PCP offices and IPAs • Provide oversight and direction for the implementation of regional clinical programs and strategies • Manage internal operational/functional relationships related to profitability • Assist with network development and provider contracting with various providers and ancillary providers • Serve as clinical liaison with inpatient facilities and joint operating committees

Job Requirements

  • MD or DO degree
  • Board Certified in an approved ABMS Medical Special
  • 8 or more years of management experience
  • A current and unrestricted license in Ohio
  • Must reside in Ohio
  • Excellent communication skills
  • 5 years of established clinical experience
  • Knowledge of the managed care industry including Medicare, Medicaid and or Commercial products
  • Possess analysis and interpretation skills with prior experience leading teams focusing on quality management, utilization management, discharge planning and/or home health or rehab
  • Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Benefits

  • medical, dental and vision benefits
  • 401(k) retirement savings plan
  • time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
  • short-term and long-term disability
  • life insurance

Related Categories

Related Job Pages

More Vice President Jobs

JLL logo

Sr. VP, Mission Critical Project Management

JLL

Jones Lang LaSalle (JLL), together with its subsidiaries and affiliates, is a leading global provider of real estate and investment management services. We take our responsibility to protect the personal information provided to us seriously.

Vice President3 days ago
OtherRemoteTeam 10,001

This role involves leading technical and complex major projects, ensuring best-in-class solutions, and maintaining strong relationships with strategic alliance clients. The incumbent will oversee the entire project delivery process from intake to closeout and manage team development and performance.

United States
$200K - $300K / year
OtherRemoteTeam 51-200

This executive role is tasked with accelerating enterprise-wide consumer engagement across the Digital Health Network, aiming to double enrollment annually while optimizing ROI by improving CAC to LTV ratios and lowering the Total Cost of Care for partners. The VP will architect engagement growth across all channels, ensuring strategy integration with product design, platform capabilities, and clinical performance, driving measurable outcomes through AI-enabled innovation.

United States
Golin logo

VP, Strategist (Healthcare)

Golin

Golin is a global public relations agency with a 60+ year history of PR with best-in-class creative that has earned worldwide attention and awards. Representing some of the biggest Fortune 500 brands, we offer a suite of services from content creation and production, diversity equity & inclusion strategy, influencer marketing, corporate strategy, and public affairs. Our healthcare practice was named the 2023 “Outstanding Agency Practice of the Year” by PRWeek.

Vice President3 days ago

Golin Health is seeking an experienced and curious Healthcare Strategy VP to concept solutions across our impressive portfolio of healthcare and pharma clients. As a strategy VP, you will: Ask questions, solve problems, and unearth audience insights. Write compelling creative bri...

United States
$125K - $225K / year
Freenome logo

Vice President, Revenue Cycle Management

Freenome

Spot the pattern. Treat the cancer.

Vice President3 days ago
OtherRemoteTeam 201-500Since 2014H1B Sponsor

Vice President overseeing revenue cycle management for a healthcare organization

United States
$261.7K - $337.8K / year