Remote VBP Innovation Lead

Humana, Inc.; Lansing (MI); Remote; USD 104,000 - 143,000; Full time

Benefits offered by this job

Remote position

Travel up to 10%

Bonus incentive plan

Job summary

Humana, Inc. is seeking a Value-Based Programs Lead to drive end-to-end support for Medicaid value-based payment models and strengthen provider relationships.

You will analyze data, design VBP strategies, and translate strategic goals into scalable models across markets in a remote-capable role. The ideal candidate has 5+ years in managed care operations and advanced knowledge of VBP and analytics, with experience in matrixed environments and Medicaid/Medicare contexts, plus strong communication

Qualifications

• Bachelor's degree.
• 5+ years of experience in managed care operations, provider reimbursement and analytics, and value-based care.
• 2+ years designing, structuring, implementing VBP strategies for specialty providers.
• Experience using data to design and model VBP arrangements, including baselines and benchmarks.
• Experience in a matrixed environment.
• Expertise in Medicare and/or Medicaid managed care.
• Strong written and verbal communication and presentation skills.

Responsibilities

• Develop innovative VBP models for various provider types (behavioral health, maternity, specialists, SDOH).
• Align work with roadmap and Medicaid contractual requirements.
• Analyze financial, utilization, and performance data to identify opportunities.
• Create VBP payment strategies and model design with metrics and terms.
• Design provider reporting packages to show performance.
• Partner with finance for impact analysis and modeling of new VBP models.
• Collaborate to operationalize and rollout VBP models and address gaps.
• Monitor KPI and iterate design based on feedback and data.
• Translate strategy into pilots scalable across markets.

Skills

Managed care operations

Provider reimbursement analytics

Value-based care design

Data analysis

Cross-functional collaboration

Presentations to management

Problem solving

Excellent communication

Education

Bachelor's degree

Master's degree

Job description

Humana, Inc. is seeking a Value-Based Programs Lead to drive end-to-end support for Medicaid value-based payment models and strengthen provider relationships.

You will analyze data, design VBP strategies, and translate strategic goals into scalable models across markets in a remote-capable role. The ideal candidate has 5+ years in managed care operations and advanced knowledge of VBP and analytics, with experience in matrixed environments and Medicaid/Medicare contexts, plus strong communication