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Regional VP Group Market Operations - South

Company: Clevelcrossing
Location: Louisville
Posted on: September 24, 2022

Job Description:

Regional VP Group Market Operations - SouthLocation
Louisville, KY, United States Posted on
Apr 30, 2021 Apply for this job your email:

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ProfileJob Information
Humana
Regional VP, Group Market Operations - South
in
Louisville
Kentucky
Description
The Regional Vice President, Employer Group Market Operations - South, will provide leadership and direction in the areas of financial and operational planning and day-to-day operations to associates in a Employer Group Region. Provides fiscal and operational oversight of the region through development and oversight of cost of care and risk management; financial planning, projections, and budget; and operational metrics and reporting, while working with market leadership, key partners within Humana and external market stakeholders. The role interfaces regularly with regional and corporate leaders.
Responsibilities
Partner with Employer Group Market and Regional leadership, product, actuary and underwriting, as well as aligned provider and clinical partners, to improve cost of care trends and drive growth within the region.
Proactively monitor and manage operational and cost of care performance across region in collaboration with regional and central resources, including Regional Presidents, Market Presidents, RVPs EG Provider Strategies, Market Medical Officers (MMOs) and Analytics. Clearly and consistently, tracks metrics and goals in order to influence and drive improvement and positive results within the region. Example areas of focus include:
Partner with Finance to establish and maintain management and performance controls by identifying, tracking, measuring and analyzing data to highlight problems, prevent losses, contain costs and direct the development of process improvements.
Partners with Group, Network Strategy, and Clinical Analytics teams to ensure the right metrics are provided and evaluated timely.
Oversight of Local Market Trend Management for the region, including proactive Book of Business .reviews to identify cost improvement opportunities
Key participant in the Employer Group Trend and Growth Management Process, governed by Employer Group Office of Quality & Affordability.
Actively engaged in decisions related to cost of care initiatives for region.
Accountable for adoption and execution of approved market-specific cost of care opportunities (e.g. clinical programs) within region.
Cultivate internal and external business relationships which will serve as resources for technical knowledge and performance improvement.
Partner closely with the Group Risk Management office, responsible for compliance within the region.
Direct the design and implementation of policies and procedures are properly integrated with other units and comply with federal and state regulatory requirements, which result in increased region performance,
Lead the financial administrative expense budgeting process for the region and works with Finance to track FTE budget.
Partner with Finance and Market Presidents to ensure market and individual sales goals are set to meet segment growth and retention goals, considering local market conditions.
Lead a market aligned team.
Tight connectivity and strong influence over MMO scorecard and ongoing prioritization of cost of care initiatives for the region.
Collaborate closely with Retail RVPs of Operations to drive tighter partnership andaccountability for shared resources and strengthen Humana's position in the region.
Hire A-players and develop team to meet and exceed results.
Collaborate with EG and enterprise partners to continuously refine focus on prioritized opportunities to execute critical business initiatives that drive profitable growth.
Required Qualifications
At least 5 years of operations and/or finance experience in the health solutions industry
Proven track record of driving operational performance improvement.
Experience taking complex data and making it more accessible, understandable and usable for leaders to derive insights.
In-depth understanding of partner-functions within and outside the segment. Understanding of how organization capabilities interrelate across segments and enterprise-wide.
Deep knowledge of the health insurance industry, competitive landscape and trends within the provider community.
Knowledge of health plan finance and the compensation arrangements between health plans and providers.
Knowledge of risk arrangements and ability to influence these arrangements by providing performance data and recommendations for improvement.
Experience building a high performing team.
Excellent communication and presentation skills.
Ability to collaborate in a positive manner.
Knowledge of Group products.
Familiarity or experience with federal and state healthcare regulations.
Bachelor's Degree in Business, Finance, Accounting or related field.
Additional Information
This
position can be located in Louisville or any Humana location within the respective region
Preferred Qualifications
Certified Public Accountant
Master's Degree in Business, Finance, Accounting or a related field
Experience working with physician groups, provider contracting, market operations, and quality and compliance functions
#MarketOpModel
Scheduled Weekly Hours
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Keywords: Clevelcrossing, Louisville , Regional VP Group Market Operations - South, Accounting, Auditing , Louisville, Kentucky

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