Director, Health Services--South Central Region

Become a part of our caring community and help us put health first

The Clinical Director is a key member of the regional clinical leadership team responsible for executing market-level clinical strategy, supporting provider performance, and coordinating with cross-functional teams to drive quality, utilization, and cost-of-care outcomes. At the core, this is a role focused on building relationships with providers and then leveraging those relationships to collaborate on how to overcome operational barriers, reduce administrative burden, and optimize clinical strategies for the benefit of our members.

Primary Responsibilities:

Health Services Director - South Central Region - (Texas, Oklahoma and Arkansas)

Clinical Strategy Execution & Provider Engagement
The Clinical Director will partner with provider leadership by:
• Developing and maintaining strong relationships with provider group leaders, ensuring timely communication, education, and collaboration.
• Strengthening relationships, enhancing clinical performance, and driving improvements in patient experience and operational excellence
• Aligning on strategic goals, sharing best practices, and collaborating on initiatives that support quality care delivery and system-wide performance
The Clinical Director will contribute to the design and operationalization of the region’s clinical strategy by:
• Driving clinical initiatives across the provider network
• Supporting facility and provider population health programs focused on Stars, HEDIS, MRA, chronic condition management, and other efforts to reduce avoidable utilization
• Supporting Joint Operating Committees (JOCs) and facilitating implementation with pilots around reducing cost of care and improving chronic health care outcomes.

Data-Driven Performance Management
Working closely with analytics and finance teams, the Clinical Director will:
• Monitor key performance indicators, identify trends in quality and utilization, and support the development of targeted action plans.
• Prepare performance dashboards, conduct root cause analyses, and facilitate provider education and remediation efforts.
• Collaborate with hospital partners to align on shared performance goals, support data transparency, and drive improvements in clinical outcomes, patient experience, and operational efficiency.
• Partner with the Regional VP of Health Services to align clinical programs with payer-specific needs and market dynamics.

Innovation & Program Implementation
The Clinical Director will implement regional pilots and vendor-supported programs, ensuring operational readiness and provider adoption. This includes:
• Advancing the rollout of remote monitoring tools, clinical pathway platforms, and other tech-enabled care solutions
• Working with hospital teams to integrate innovative solutions into inpatient and transitional care workflows, tracking program performance, escalating barriers to adoption, and contributing to continuous improvement efforts that enhance both provider and patient experience.

Governance & Delegation Oversight
The Clinical Director will participate in governance committees and support vendor and delegation oversight activities, including:
• Ensuring compliance with clinical policies, quality standards, and regulatory requirements
• Collaborating with hospital leadership to align governance practices
• Promoting operational excellence across delegated entities and facility-based care settings.

Use your skills to make an impact

Qualifications:

• Clinical degree with active unrestricted license (e.g. RN, NP,)
• 5+ years of experience in clinical operations, care management, or provider performance improvement.
• 5+ years experience in managed care industry, either provider or payer.
• Strong understanding of value-based care, population health, and quality metrics (e.g., Stars, HEDIS, MRA).
• Proficiency in quickly monitoring clinical and financial data and communicating it to drive decision-making and action across teams.
• Demonstrate ability to manage cross-functional projects and collaborate with clinical and non-clinical stakeholders.
• Excellent written and verbal communication skills; comfortable engaging executive and clinical audiences.
• Must be able to travel up to 30-35% in South Central Region (Texas, Oklahoma, Arkansas)

Preferred:

• Experience in both provider and payer roles.
• Prior executive level role with successful track record of building external relationships and driving quality and financial results in a collaborative team/matrixed environment.
• Advanced degree in business, management and/or population health.

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.$138,900 - $191,000 per yearThis 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

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and 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, Medicaid, families, individuals, military service personnel, and communities at large.

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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.

Originally posted on Himalayas

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