Remote Value-Based Care Strategy Lead

Humana Inc; Austin (TX); Remote; USD 104,000 - 143,000; Full time

Benefits offered by this job

Bonus incentive plan

Job summary

Humana Inc. is seeking a Value-Based Programs Lead for Humana Healthy Horizons to advance Medicaid value-based models and provider relationships. You will own end-to-end operational support, model design, and performance reporting in a remote capacity.

The role requires 5+ years in managed care operations, VBP expertise, and Medicare/Medicaid knowledge, with opportunities to influence care with data-driven insights. Travel may reach 10%.

Qualifications

• Bachelor's degree in a related field.
• Minimum 5 years in managed care operations, provider reimbursement and analytics.
• Expertise in VBP model design and strategy with specialty providers.
• Experience with Medicare and/or Medicaid managed care.
• Ability to analyze financial, utilization and performance data.
• Strong communication and presentation skills.

Responsibilities

• Develop and manage new VBP models for various provider types.
• Align VBP development with Medicaid requirements and RFP commitments.
• Analyze data to identify quality and cost improvement opportunities.
• Design VBP payment strategies, metrics and financial terms.
• Create provider reporting packages to inform performance.
• Collaborate with finance to model impact of new models.
• Support rollout of VBP models across markets.
• Monitor KPIs and refine model designs.

Skills

VBP design

Provider reimbursement

Analytics

Strategic thinking

Communication

Education

Bachelor's degree

Master's degree (preferred)

Tools

Medicare/Medicaid knowledge

Job description

Humana Inc. is seeking a Value-Based Programs Lead for Humana Healthy Horizons to advance Medicaid value-based models and provider relationships. You will own end-to-end operational support, model design, and performance reporting in a remote capacity.

The role requires 5+ years in managed care operations, VBP expertise, and Medicare/Medicaid knowledge, with opportunities to influence care with data-driven insights. Travel may reach 10%.