Humana · 21 hours ago
VP, National Provider Network Management
Louisville, KY
Full-time
Onsite
Senior Level, Lead/Staff
10+ years expHumana is a market leader in integrated healthcare, seeking a Vice President for National Provider Network Management. This role involves defining negotiation strategies with provider organizations and fostering strategic relationships to improve community health.
Health CareHealth InsuranceInsuranceVenture Capital
Responsibilities
Develop and lead national provider network strategy across Medicare and Medicaid segments, including but not limited to Integrated Delivery Networks, Specialty payment innovation, Ancillary providers, Behavioral Health and the post acute delivery network
Strategic Partner with all segments of Humana's Insurance Business, accountable for developing and maintaining strategic network relationships with large national providers. Ensure adequate coverage of primary care, specialty and ancillary services for Humana to meet both regulatory and sales support need
Align strategy and priority between different segments/functions and be the defined point of contact for escalated provider engagements and issues
Establish enterprise wide contracting standards, best practices and policies for Medicare and Medicaid lines of business. Collaborate across departments and market teams to implement those practices
Lead Enterprise change efforts regarding contract standardization, creating simplified processes and policies for our contractors and providers. Ensure access to care for members, network adequacy and gap closure
Develop and lead trend initiatives with key providers and partners
Executive leadership of Provider Performance and Analytics functions, supporting Humana's value-based contracts and trend bender initiatives
Manage across a highly matrixed organization aligning priorities and results at a national and regional level
Provide leadership to a team of executives and their staff, driving associate engagement initiatives, developing and managing talent, and leading change efforts
Qualification
Required
Bachelor's degree
10 plus years contracting and/or managing relationships with Integrated Delivery Systems
6 plus years business leadership experience, with several years in a managed care environment leading a network development/provider relations function, including proven experience leading contracting for Medicare and Medicaid products
Experience leading the 'end-to-end' contract negotiation process through closure for different types of providers (hospitals, physicians, sub-acute care facilities) pharmacy networks and delegated specialty services across all health insurance product lines
Proven skill in driving results, thinking strategically and executing strategy effectively; thinking at an enterprise level
Knowledge of risk arrangements and ability to influence these arrangements
Record of success leading the delivery of large, enterprise-scale initiatives involving multiple functions and business segments
Strong relationship management skills, to teach, tailor, and take control of opportunity definition and initiation with business partners
Proven results in building teams and strong culture leader
Comprehensive knowledge of health plan finance and the compensation arrangements between health plans and providers, including plan funding, risk management and provider reimbursement
Preferred
MBA and/or JD degree
The ability to identify health service expenses and implement cost control mechanisms within contracts
Prior executive leadership experience in sales, finance, legal, health services, and/or medical management; demonstrated ability to partner across functions to create and deploy win/win strategies
Executive leadership experience, setting vision and goals, aligning talent, developing teams, leading positively and leading through change
Recognition as a thought leader in the area of healthcare trend mitigation
Ability to effectively navigate and manage through a matrixed organizational environment in a large (Fortune 250) company
Proven track record in team development and preparing direct reports for expanded responsibilities
Company
Humana
Humana is a health insurance provider for individuals, families, and businesses.
10001+ employees
H1B Sponsorship
Humana has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (282)
2024 (246)
2023 (284)
2022 (274)
2021 (212)
2020 (84)
Funding
Current Stage
Public CompanyTotal Funding
$13.07B2025-05-30Post Ipo Debt· $5B
2025-03-03Post Ipo Debt· $1.25B
2024-03-11Post Ipo Debt· $2.25B
Leadership Team
Jim Rechtin
CEO and President
Caleb Gallifant
Chief Operating Officer, CenterWell Home Health
Recent News
2026-02-03
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