Regional VP, Health Services Pacific Southwest Region

Regional VP of Health Services, Humana Medicare Advantage

The Regional VP, Health Services relies on medical background to create and oversee clinical strategy for the region. The Regional VP, Health Services requires an in-depth understanding of how organization capabilities interrelate across segments and / or enterprise-wide.

As the Regional VP of Health Services, you will serve as the senior clinical executive responsible for shaping and executing the region's clinical engagement strategy. This role drives quality improvement, cost efficiency, and population health outcomes through strategic provider partnerships, data-informed decision-making, and cross-functional collaboration. The RVP acts as a key advisor, innovator, and relationship builder, ensuring alignment with Humana's mission and Medicare Advantage goals.

Primary Responsibilities

Clinical Engagement & Provider Strategy :

• Cultivate and maintain trusted relationships with CMOs and senior executive / clinical leaders at provider and care delivery partner organizations.
• Serve as lead clinical executive for provider groups, translating clinical and quality priorities into actionable strategies.
• Enhance innovation with hospital systems while fostering collaboration and reducing operational barriers.
• Drive population health initiatives to improve the health and well-being of our members including :
• A strong understanding of clinical metrics and data (e.g. Quality measures, Risk Adjustment ratings, chronic condition management, PCP visit rates and effectiveness, and member engagement strategies).
• Identifying and implementing initiatives to address total cost of care drivers.
• Championing condition-based interventions.
• Leading clinical strategies to manage unique populations, such as unattributed membership, low income, disabled, or special needs members.

Clinical Strategy & Market Performance :

Innovation & Transformation :

Qualifications :

Preferred :

Travel : While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours 40

Pay Range $298,000 - $409,800 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and / or individual performance.

Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities.

About Us

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. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.