Humana
Regional VP, Health Services - Midwest Region
Join to apply for the
Regional VP, Health Services - Midwest Region
role at
Humana This range is provided by Humana. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range
$298,000.00/yr - $409,800.00/yr Become a part of our caring community and help us put health first 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. Regional VP of Health Services, Humana Medicare Advantage 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. This role focuses on building relationships with providers and leveraging those relationships to drive provider performance, overcome operational barriers, and reduce administrative burden. Serve as lead clinical executive for provider groups, translating clinical and quality priorities into actionable strategies. Promote growth and innovation with all provider groups, particularly CenterWell partners. Enhance innovation with hospital systems while fostering collaboration and reducing operational barriers. Drive population health initiatives to improve member health and well-being, including: Understanding clinical metrics and data (Quality measures, Risk Adjustment, chronic condition management, PCP visit rates and effectiveness, member engagement). Identifying and implementing initiatives to address total cost of care drivers. Champaigning condition-based interventions. Leading clinical strategies to manage unique populations (unattributed membership, low income, disabled, or special needs). Clinical Strategy & Market Performance
Serve as the clinical steward for regional medical expense trends, using data to guide interventions and ensure fiscal accountability. Collaborate with finance, analytics, and market leadership to identify cost and quality outliers and implement targeted action plans. Customize strategies to align clinical programs with payer-specific needs (MA, D-SNP). Provide clinical input into network development, contract negotiations, and delegation oversight. Serve as clinical subject matter expert for potential plan design and clinical programs to support continued health plan growth. Represent the organization in regional health coalitions and community health initiatives. Collaborate with various operational functions in the centralized utilization management team and other shared services. Participate in quality governance, peer review, and grievance resolution processes. Innovation & Transformation
Partner with national innovation teams to pilot and scale emerging technologies and care models (e.g., remote monitoring, clinical pathways, tech-enabled care). Lead regional implementation of clinically focused strategic programs. Collaborate with vendor partnerships and evaluate performance against clinical and financial KPIs. May also be involved in governance committees and delegation oversight. Qualifications
Active MD or DO licensure with appropriate training and certification 5+ years clinical practice 5+ years in the managed care industry (provider or payer) Thorough knowledge of health care utilization and quality metrics and the impact of value-based contracting on provider behavior Ability to monitor clinical metrics and convey impact verbally and in writing Proficient communication skills (interpersonal, written, presentation) and ability to simplify complex material Strategic thinker with ability to balance long-term vision and short-term execution Established track record of building successful teams and cross-departmental relationships Travel required 25%-30% Reside within the region’s geographic boundaries Preferred
Experience in both provider and payer roles Prior executive level role with a track record of building external relationships and driving quality and financial results in a collaborative environment Advanced degree in business, management and/or population health Travel: While this is a remote position, occasional travel to Humana 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. $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 offers competitive benefits that support whole-person well-being, including medical, dental and vision benefits, 401(k) retirement savings, time off (paid time off, holidays, volunteer time off, paid parental and caregiver leave), disability, life insurance, and more. About Us
Humana Inc. (NYSE: HUM) is committed to putting health first – for teammates, customers and the company. Through Humana insurance services and CenterWell healthcare services, we aim to help people achieve their best health. Equal Opportunity Employer
Humana does not 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. Humana is an equal opportunity employer and takes affirmative action to employ and advance in employment individuals with disabilities or protected veteran status, based on valid job requirements.
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Join to apply for the
Regional VP, Health Services - Midwest Region
role at
Humana This range is provided by Humana. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. Base pay range
$298,000.00/yr - $409,800.00/yr Become a part of our caring community and help us put health first 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. Regional VP of Health Services, Humana Medicare Advantage 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. This role focuses on building relationships with providers and leveraging those relationships to drive provider performance, overcome operational barriers, and reduce administrative burden. Serve as lead clinical executive for provider groups, translating clinical and quality priorities into actionable strategies. Promote growth and innovation with all provider groups, particularly CenterWell partners. Enhance innovation with hospital systems while fostering collaboration and reducing operational barriers. Drive population health initiatives to improve member health and well-being, including: Understanding clinical metrics and data (Quality measures, Risk Adjustment, chronic condition management, PCP visit rates and effectiveness, member engagement). Identifying and implementing initiatives to address total cost of care drivers. Champaigning condition-based interventions. Leading clinical strategies to manage unique populations (unattributed membership, low income, disabled, or special needs). Clinical Strategy & Market Performance
Serve as the clinical steward for regional medical expense trends, using data to guide interventions and ensure fiscal accountability. Collaborate with finance, analytics, and market leadership to identify cost and quality outliers and implement targeted action plans. Customize strategies to align clinical programs with payer-specific needs (MA, D-SNP). Provide clinical input into network development, contract negotiations, and delegation oversight. Serve as clinical subject matter expert for potential plan design and clinical programs to support continued health plan growth. Represent the organization in regional health coalitions and community health initiatives. Collaborate with various operational functions in the centralized utilization management team and other shared services. Participate in quality governance, peer review, and grievance resolution processes. Innovation & Transformation
Partner with national innovation teams to pilot and scale emerging technologies and care models (e.g., remote monitoring, clinical pathways, tech-enabled care). Lead regional implementation of clinically focused strategic programs. Collaborate with vendor partnerships and evaluate performance against clinical and financial KPIs. May also be involved in governance committees and delegation oversight. Qualifications
Active MD or DO licensure with appropriate training and certification 5+ years clinical practice 5+ years in the managed care industry (provider or payer) Thorough knowledge of health care utilization and quality metrics and the impact of value-based contracting on provider behavior Ability to monitor clinical metrics and convey impact verbally and in writing Proficient communication skills (interpersonal, written, presentation) and ability to simplify complex material Strategic thinker with ability to balance long-term vision and short-term execution Established track record of building successful teams and cross-departmental relationships Travel required 25%-30% Reside within the region’s geographic boundaries Preferred
Experience in both provider and payer roles Prior executive level role with a track record of building external relationships and driving quality and financial results in a collaborative environment Advanced degree in business, management and/or population health Travel: While this is a remote position, occasional travel to Humana 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. $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 offers competitive benefits that support whole-person well-being, including medical, dental and vision benefits, 401(k) retirement savings, time off (paid time off, holidays, volunteer time off, paid parental and caregiver leave), disability, life insurance, and more. About Us
Humana Inc. (NYSE: HUM) is committed to putting health first – for teammates, customers and the company. Through Humana insurance services and CenterWell healthcare services, we aim to help people achieve their best health. Equal Opportunity Employer
Humana does not 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. Humana is an equal opportunity employer and takes affirmative action to employ and advance in employment individuals with disabilities or protected veteran status, based on valid job requirements.
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