Principal, Provider Network Transition Strategy

## Principal, Provider Network Transition Strategy Apply:
Remote Nationwide:
Full time:
Posted Today:
R-431815#
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** The Principal, Provider Network Transition Strategy serves as an enterprise leader responsible for developing and advancing Humana's strategy for significant provider network changes and disruption events. This highly visible individual contributor role partners across Provider Contracting, Market Operations, Member Experience, Stars, Sales, Service, Compliance, and executive leadership teams to assess risk, develop mitigation strategies, and improve organizational readiness related to provider network transitions.
The Principal leads complex, enterprise-wide initiatives that influence member access, provider experience, business performance, and operational outcomes. Success in this role requires deep provider network expertise, strong executive presence, and the ability to drive results through influence in a highly matrixed environment where execution is performed across multiple business areas.

The Principal, Provider Network Transition Strategy is responsible for leading strategic programs that support Humana's readiness and response to provider network changes, including provider terminations, large-scale provider transitions, and other events impacting member access and provider relationships.  As a recognized enterprise subject matter expert, this role works across organizational boundaries to identify risks, improve business processes, and build a Provider Network Transitions Program that enhance the provider, member, and associate experience.

The Principal partners closely with senior leaders to evaluate operational, regulatory, financial, and member impacts while helping the organization execute coordinated responses to provider network change.

This role does not directly own operational execution. Instead, the Principal drives enterprise alignment, facilitates decision-making, and influences outcomes through partnership with leaders across multiple business functions.
* Lead Humana's enterprise strategy for provider network transition and disruption management initiatives, including assessment of member, provider, operational, regulatory, and business impacts.
* Serve as the enterprise lead for provider termination and provider network transition programs, ensuring cross-functional alignment and organizational readiness.
* Partner with Provider Contracting, Market Leadership, Member Retention, Stars, Provider and Member Service, Compliance, Provider Network Operations, and other key stakeholders to develop and implement mitigation strategies.
* Proactively identify emerging provider network risks and opportunities, developing recommendations for senior leadership regarding readiness, response, and enterprise prioritization.
* Drive initiatives that improve provider and member experiences during periods of provider network change while reducing operational friction and execution risk.
* Facilitate executive governance and decision-making processes related to provider network transitions and enterprise risk mitigation.
* Develop and maintain enterprise visibility into significant provider network events through reporting, analytics, executive communications, and performance monitoring.
* Utilize data and business insights to evaluate downstream impacts of provider network changes on member retention, access to care, network adequacy, Stars performance, service operations, and overall business performance.
* Lead cross-functional efforts to simplify processes, improve coordination across teams, and strengthen enterprise capabilities related to provider network transitions.
* Influence leaders and stakeholders across a matrixed organization to drive accountability, remove barriers, and achieve desired business outcomes without direct operational ownership.
* Advise senior leaders and executives on strategic initiatives, organizational risks, and opportunities related to provider network change management.
* Identify and prioritize future opportunities that enhance Humana's ability to effectively manage provider network transitions and disruption events.#
** Use your skills to make an impact
**** Required Qualifications
*** 7+ years of experience in provider contracting, provider network management, healthcare operations, healthcare consulting, or related healthcare strategy roles
* 3+ years of project, program, or people leadership experience
* Strong understanding of provider…