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Job Description
Job Listing ID:
4490197
Job Title:
Director, CMS & Provider Direct Channel Application Deadline:
Open Until Filled
Job Location:
Salem
Date Posted:
05/12/2026
Hours Worked Per Week:
Not Provided Shift:
Not Provided Duration of Job:
Either Full or Part Time, more than 6 months You may contact this employer directly.
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Job Summary:
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 continuous improvement. Use your skills to make an impact Required Qualifications Bachelor's degree in business, healthcare administration, or a related field 6+ years of progressive leadership experience in interoperability, digital health, healthcare technology, product management, regulatory delivery, or related functions, ideally in healthcare Experience leading delivery of API-based capabilities, regulatory programs, or provider-facing interoperability solutions. Strong understanding of CMS interoperability requirements, healthcare data exchange, provider workflows, and operational execution Proven ability to lead across business, compliance, operational, and technology teams Demonstrated ability to analyze complex issues, communicate effectively and drive solutions Track record of driving execution in complex, cross-functional environments Preferred Qualifications Master's degree in business, healthcare administration, or related field Experience working with national interop...
Job Classification:
Marketing Managers Access our statewide or regional occupation report for more information about wages,
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