Regional VP Mid Atlantic Medicare Operations

Profile

Description

The Regional VP, Operations in the Mid-Atlantic Medicare region is a Chief Financial Officer position with Operations elements as well. This person collects, analyzes and reports on various market data and trends to connect financial outcomes with operational effectiveness. The Regional VP, Operations requires an in-depth understanding of how organization capabilities interrelate across segments and/or enterprise-wide to develop strategies to improve outcomes that support the region’s membership, medical expense, admin and margin targets.

Responsibilities

The Regional Vice President, Operations, will provide leadership and direction in the areas of financial and operational planning and day to day operations to a team of local and national associates. This individual will provide fiscal and operational oversight of the Mid-Atlantic region senior products through development and oversight of the annual budget, financial planning and projections, risk management and operational metrics and reporting while working with value-based providers, physicians, IPAs and MSO leadership. The role interfaces regularly with regional, divisional and corporate leaders.


Develop strategic and operational action plans and objectives for the business unit and a fiscally responsible budget that supports its strategy

Direct the design and implementation of policies and procedures which result in increased performance, are properly integrated with other units, and comply with federal and state regulatory requirements

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

Active engagement in the bid development and creative process to ensure market competitive products designed for growth and profitability

Cultivate internal and external business relationships which will serve as resources for technical knowledge and performance improvement


Required Qualifications


Knowledge of Medicare and participation in the annual bid process

At least 5 years of operations and/or finance experience in the health solutions industry (preferably a CFO role or COO with finance experience)

Experience building a high performing team to support a growth market

Excellent communication and presentation skills

Ability to collaborate in a positive manner

Progressive management and leadership experience with associates in multiple locations

Willingness to travel a minimum of 20%

Bachelor’s Degree in Business, Finance, Accounting or a related field

Resides or Relocate to Richmond VA area


Preferred Qualifications


Certified Public Accountant

Master's Degree in Business, Finance, Accounting or a related field

Knowledge of the local market dynamics – NC, VA, DE, MD

Knowledge of both group and individual Medicare products

Experience working with physician groups, provider contracting, market operations, and Medicare Risk Adjustment and Stars/Quality functions

Familiarity or experience with CMS bid mechanics and bid tools


Scheduled Weekly Hours

40

About Us

Mission: At Humana, our cultural foundation is aligned to helping members achieve their best health by delivering personalized, simplified, whole-person healthcare experiences. Recognizing healthcare needs continue to evolve for each person, for each family and for each community, Humana continuously creates innovative solutions and resources that help people live their healthiest lives on their terms –when and where they need it. Our employees are at the heart of making this happen and that’s why we are dedicated to building an organization of dynamic talent whose experience and passion center on putting the customer first.

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