Medicaid Value-Based Programs Lead (Remote)

Humana, Inc.; Olympia (WA); Remote; USD 104,000 - 143,000; Full time

Benefits offered by this job

Remote position

Up to 10% travel

Competitive benefits

Job summary

Humana Healthy Horizons is seeking a Value-Based Programs Lead to drive successful value-based provider relationships and improve the provider experience while achieving path-to-value goals.

You will lead the end-to-end operational support of Medicaid VBP models, align models with contract and RFP requirements, and collaborate with finance for impact analysis. This remote role offers travel up to 10% and opportunities to influence care models at scale.

Qualifications

• Bachelor's degree required; advanced degree preferred.
• Experience with value-based care and provider reimbursement.
• Strong analytics, modeling, and data interpretation skills.
• Proven ability to lead in a matrixed organization.

Responsibilities

• Lead end-to-end operational support for Medicaid VBP models.
• Develop and align VBP models with Medicaid requirements and RFPs.
• Analyze data to identify quality and cost-of-care improvements.
• Design VBP payment strategies, metrics, and benchmarks.
• Create provider reporting packages to show performance.
• Partner with finance for impact analysis and modeling.

Skills

VBP strategy

Provider reimbursement

Analytics

Matrixed environment

Communication

Project leadership

Education

Bachelor's degree

Master's degree

Job description

Humana Healthy Horizons is seeking a Value-Based Programs Lead to drive successful value-based provider relationships and improve the provider experience while achieving path-to-value goals.

You will lead the end-to-end operational support of Medicaid VBP models, align models with contract and RFP requirements, and collaborate with finance for impact analysis. This remote role offers travel up to 10% and opportunities to influence care models at scale.