Value Based Expert

Hire Virtual Team (HVT) Global Solutions; Taguig; Hybrid; PHP 1,800,000 - 2,100,000; Full time

Job summary

Hire Virtual Team (HVT) Global Solutions is hiring a Value-Based Expert to lead healthcare financial strategy, value-based payment performance, and managed care initiatives. This hybrid role requires strong analytics and collaboration with clinical and finance teams.

You will develop models, dashboards, and forecasts, mentor analysts, and support negotiations with payers. Schedule is Monday-Friday; office presence 2x weekly.

Qualifications

• 5+ years in healthcare finance or payer analytics.
• Experience in value-based contract development, including performance measurement, attribution, quality metrics, reconciliation, and dispute resolution/appeals.
• Forecasting, auditing, and predictive analytics for contract performance management.
• Proven analytics driving measurable business actions.
• Strong communication translating data to insights for technical and non-technical audiences.

Responsibilities

• Prepare analyses for managed care contract negotiations and payer strategy.
• Design value-based payment models and attribution methodologies.
• Develop pro forma, sensitivity, and stress-test analyses for utilization and cost scenarios.
• Monitor contract and value-based program performance, identify risks and unfavorable trends.
• Develop monthly forecasts and financial reports on value-based performance.
• Conduct quarterly and annual reconciliations to ensure payer contract compliance.
• Develop analytical tools to monitor healthcare trends and forecast performance.
• Analyze payer data and market trends to support negotiation strategies and enterprise decisions.
• Create executive dashboards for clinical and financial stakeholders.
• Build scalable, repeatable analytic processes across value-based programs.
• Mentor Managed Care Analysts and guide process improvements.

Skills

SQL

Tableau

Power BI

Financial modeling

Payer analytics

Communication

Forecasting

Education

Bachelor's degree in STEM/related field

Master's degree preferred

Tools

SQL

Tableau

Power BI

Job description

We're hiring for the position of Value-Based Expert, play a key role in driving healthcare financial strategy, value-based payment performance, and managed care initiatives.

Work Setup: Hybrid – 2x in office

Schedule: Monday to Friday

KEY RESPONSIBILITIES

• Prepare advanced reimbursement, financial impact, and performance analyses to support managed care contract negotiations and payer strategy.
• Design and evaluate value-based payment models, including shared savings, quality metrics, risk corridors, and attribution methodologies.
• Develop pro forma, sensitivity, and stress-test analyses to assess financial outcomes under different utilization and cost scenarios.
• Monitor contract and value-based program performance, identifying underpayments, compliance gaps, unfavorable payment trends, and financial risks.
• Develop monthly forecasts and financial reports covering value-based performance, payment reconciliation, and variance analysis.
• Conduct quarterly and annual reconciliation audits to ensure payer compliance with contractual terms.
• Develop innovative analytical tools and methodologies to monitor healthcare trends and forecast value-based performance.
• Analyze payer data, market trends, and industry developments to support negotiation strategies and enterprise decision-making.
• Create executive-ready dashboards and visualizations tailored to both clinical and financial stakeholders.
• Build scalable and repeatable analytical processes across value-based programs.
• Mentor Managed Care Analysts and provide technical guidance and support for process improvements.

QUALIFICATIONS:

• Bachelor’s degree in STEM, Economics, Actuarial Science, Health Economics, Business Administration, Finance, Accounting, Healthcare Administration, or a related field.( Master’s degree in MBA, MHA, MPH, Finance, or a related field is preferred)
• 5+ years of progressive experience in healthcare finance, payer analytics, medical economics, healthcare consulting, or a related field.
• Proven experience developing analytics that drive business decisions and measurable actions.
• Experience supporting value-based contract development, including performance measurement, attribution, quality metrics, reconciliation, and dispute resolution/appeals.
• Experience in forecasting, auditing, and predictive analytics for contract performance management.
• Advanced proficiency in SQL, Tableau, and/or Power BI.
• Experience working with large healthcare claims, reimbursement, and/or value-based performance datasets.
• Strong communication skills with the ability to translate complex data into clear, strategic insights for technical and non-technical audiences.

A BIG PLUS IF YOU HAVE:

• Familiarity with actuarial concepts such as IBNR, shared savings, and risk-based financial reporting.
• Knowledge of CMS programs, Medicare Advantage, Medicaid, and HCC risk adjustment methodologies.
• Deep understanding of managed care contracts, reimbursement methodologies, and value-based payment models.