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Regional Vice President of Contracting for CarePlus
The Regional VP manages the development, operations, and results of a health plan. The Regional VP requires a in-depth understanding of how organization capabilities interrelate across segments and/or enterprise-wide.
The Regional VP establishes long-range goals, objectives, and plans; monitors financial and operational performance; and coordinates activities of senior managers and their respective functions. Represents the health plan externally and to governmental/external agencies. Decisions are typically related to intradepartmental coordination, development and implementation of strategic plans, and business outcomes, and develops and implements strategic plans for the scope of management that are aligned with the Segment or Business strategy.
The RVP partners closely with Medical, Network Operations, Finance, Product, Legal, and Market Leadership to deliver competitive, compliant, and high-performing provider networks across for the CarePlus Market.
Key Responsibilities
Provider Contracting & Network Strategy
- Develop and execute regional provider contracting and network strategies aligned with enterprise goals, market dynamics, and regulatory requirements.
- Lead negotiations with health systems, hospitals, physician groups, ancillary providers, and post-acute partners.
- Optimize network adequacy, access, affordability, and geographic coverage across lines of business.
Financial & Performance Management
- Accountable for medical cost management, contract yield, and provider reimbursement outcomes within the region.
- Drive performance against trend, unit cost, value-based reimbursement, and quality targets.
- Partner with Finance to manage regional budgets, forecasts, and ROI related to contracting initiatives.
Value-Based Care & Innovation
- Expand and mature value-based care (VBC) arrangements, including shared savings, full-risk, bundled payments, and alternative reimbursement models.
- Collaborate with Clinical and Quality teams to improve outcomes, STAR ratings, HEDIS measures, and provider performance.
Leadership & Talent Development
- Lead and develop a multi-layered team of contracting and network leaders.
- Build strong succession plans and foster a culture of accountability, innovation, and collaboration.
- Serve as an executive mentor and coach to regional and market-level leaders.
Market & Enterprise Collaboration
- Act as a key regional executive partner to Market Presidents, Medical Directors, and Enterprise Network leadership.
- Influence enterprise policy, contracting standards, and best practices based on regional insights.
- Represent the organization in external provider forums, industry partnerships, and strategic discussions.
Compliance & Risk Management
- Ensure full compliance with state, federal, CMS, and regulatory requirements, including network adequacy and credentialing standards.
- Partner with Legal and Compliance to oversee contract risk, disputes, and regulatory audits.
Use your skills to make an impact
Required Qualifications
- Bachelor's Degree
- 10 years of experience in the healthcare industry, with a strong preference for Medicare Advantage value-based models and 3–5 years of direct experience in the Florida market.
- Proven track record of driving operational performance improvement and Senior Leadership experience
- Proven experience developing multi-product strategy at the market level or higher.
- Excellent verbal and written communications skills
- Experience leading the end-to-end contract negotiation process through closure for all types of providers (physicians, hospitals, post-acute care facilities) and delegated specialty services.
- Comprehensive knowledge of health plan finance and the compensation arrangements between health plans and providers
- Knowledge of risk arrangements and ability to influence these arrangements.
- Solid track record of hiring and developing talent and preparing associates for roles of broader and greater responsibility
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred Qualifications
- Master's or J.D. degree
- Record of success leading provider contracting and provider engagement activities for all lines of business
- Experience within national or large regional health plans (Commercial, Medicare Advantage, Medicaid).
- Demonstrated ability to lead in matrixed, highly regulated environments.
- Executive-level negotiation, influence, and stakeholder management skills.
- Strong analytical orientation with ability to translate data into strategic action.
- Excellent communication skills with comfort presenting to C-suite, Boards, and external partners.
- Preferred locations are South Florida or Central Florida (Tampa/Orlando) with the ability to travel across Florida and to other corporate offices as needed.
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
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$203,400 - $279,800 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
About CarePlus Health Plans: CarePlus Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to help people with Medicare, or both Medicare and Medicaid, achieve their best possible health and wellness through plans with benefits and services they care about. As a wholly owned subsidiary of Humana, CarePlus currently serves Medicare beneficiaries throughout 21 Florida counties.
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our 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 and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.
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.