Director, CMS & Provider Direct Channel

Director, CMS & Provider Direct Channel at Humana in Boise, Idaho, United States Job Description Become a part of our caring community The Director, CMS & Provider Direct Channel (Director, Product Management) leads Humana's connectivity strategy across CMS-mandated and direct interoperability channels. This leader is accountable for execution across CMS compliance APIs, voluntary exchange pathways, and direct-to-provider connectivity efforts. The role focuses on translating regulatory requirements and market opportunities into scalable capabilities, stronger provider adoption, and measurable business value. You will report to AVP, Interoperability. Primary Responsibilities + Lead strategy and execution for the CMS & Provider Direct Channel, including CMS compliance APIs, voluntary interoperability capabilities, and direct-to-provider connectivity. + Own channel performance across regulatory delivery, provider adoption, and ongoing channel expansion. + Translate CMS requirements, policy direction, and enterprise priorities into practical channel strategies and executable roadmaps. + Partner across product, technology, operations, compliance, legal, and business teams to deliver compliant, scalable, and provider-ready capabilities. + Drive adoption of CMS and direct connectivity solutions by aligning channel capabilities to provider needs and business priorities. + Oversee execution for provider-facing APIs and direct exchange capabilities that improve access, reduce friction, and enable interoperability at scale. + Define and manage KPIs for channel readiness, compliance execution, adoption, utilization, and performance. + Support external engagement tied to CMS mandates, voluntary commitments, and direct provider connectivity opportunities. + Identify risks, dependencies, and execution barriers early, and drive cross-functional resolution. + Lead and develop a strong team across channel delivery, partner coordination, and execution management. + Continuously monitor regulatory change, market movement, and provider demand to strengthen channel performance over time. Outcomes + Strong execution against CMS interoperability requirements and timelines. + Reliable, scalable CMS compliance API capabilities. + Greater provider adoption of direct and voluntary connectivity solutions. + Simpler provider access to Humana data through compliant and practical exchange pathways. + Stronger alignment between regulatory commitments and enterprise priorities. + Clear channel performance through defined metrics, active management, and

Job Posting:

JC291587827

Posted On:

May 09, 2026

Updated On:

May 09, 2026