MSO Network Management Executive

Job Description: Humana Inc., headquartered in Louisville, Ky., is one of the nation's largest publicly traded health benefits companies, with approximately 9 million medical members. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals.

Over its 45-year history, Humana has consistently seized opportunities to meet changing customer needs. Today, the company is a leader in consumer engagement, providing guidance that leads to lower costs and a better health plan experience throughout its diversified customer portfolio.


Role: MSO (Medical Service Operations) Network Management Executive
Location: Miramar, FL

Are you a fit?
Are you a positive, passionate and highly motivated professional? Are you an innovative thinker? Are you capable of building long term relationships in a competitive environment while maintaining the highest standards of integrity and respect? Are you an innovative thinker? Do you have a strong attention to detail and like solving problems?

Assignment Capsule
The MSO Network Management Executive will oversee the development and implementation of long- and short-term strategic and tactical plans for the MSO network management organization. This individual is responsible for managing the area's performance and its impact to the market's financial and strategic objectives. He/she will ensure operational alignment with the strategic plan of the market and enlist others in the pursuit of the market and company's vision. This is a Senior Director level position.


Works collaboratively with Senior leadership of the South Florida market with developing strategies to maximize profitable growth in the market while maintaining a strong network of providers, clinics and hospitals.


Drive the effective growth of the market's MSO network, while focusing on continued profitable growth of membership.


Educate MSOs/IPAs/PCPs on maximizing network efficiencies and issues in order to improve profitability.


Recruit new physicians with potential Medicare membership growth.


Assists with the development of network contracting strategies in coordination with the Vice President of Contracting.


Assures network adequacy for the Medicare and Medicaid lines of business.


Develop and maintain strong relationships with providers, including MSOs, IPAs, etc.


Monitor/improve performance of providers through planning, developing corrective action plans, establishing new network arrangements, negotiating better deals, etc. to help sell the value proposition.


Constantly monitor the effectiveness of the network and recommend expansion of providers and clinics where appropriate.


Geographic footprint: Dade, Broward and Palm Beach counties.


Span of control: 10 direct reports; 50 indirect reports.



Key Competencies


Acts Strategically: You foster a consistent understanding of strategy, translate it into defined plans, and "stay the course" to implement it, while anticipating and identifying where change is needed.

Builds Human Capital: You deliver current, direct, complete and actionable feedback to associates to support continuous learning and growth; while ensuring that diverse perspectives are widely held, modeled and promoted. By selecting, deploying, developing and rewarding diverse talent, you are able to foster Humana's strategy and meet business requirements.

Builds Trust: You honor your word by doing what you say you are going to do.

Champions the Customer: You keep closely attuned to the needs and perspectives of customers and use this insight for the benefit of the business.

Communication: You actively listen to others to understand their perspective and ensure continuous understanding regardless of communication channel or audience.

Drives for excellence: You are a continuous leaner who encourages others to learn. By constantly upgrading your own work, you achieve results and outperform the competition.

Is Accountable: You meet clearly stated expectations and take responsibility for achieving results.

Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. Acting as both a broker and consultant regarding resources, you engage others in problem solving without taking over.

Searchable Keywords: MSO Network Management Executive / gj-mo

Minimum Education Required: Bachelor

Years of Experience Required: More than 5 years

Expected Travel Time: About 25%