Value-Based Programs Architect — Remote

Humana Inc; Montpelier (VT); Remote; USD 104,000 - 143,000; Full time

Benefits offered by this job

Remote position

Bonus eligibility

Up to 10% travel

Job summary

Humana Inc. seeks a Value-Based Programs Lead for a remote role dedicated to strengthening value-based provider relationships and advancing Medicaid VBP initiatives. You will lead end-to-end operational support, model design, and reporting to improve quality and reduce total cost of care.

The candidate should have 5+ years in managed care operations and VBP design, with strong analytical and communication skills. Expect Mon-Fri EST hours and up to 10% travel.

Qualifications

• Bachelor's degree required.
• Minimum 5 years of experience in managed care operations, provider reimbursement and analytics, and value-based care.
• Expertise in VBP model design and strategy with specialty providers, including pay for performance, bundles, accountable care, and shared savings and risk models.
• Expertise in Medicare and/or Medicaid managed care.
• Ability to understand and analyze financial, utilization, and performance data.
• Ability to identify, structure and solve complex business problems.
• Experience operating in matrixed environment.
• Excellent interpersonal, organizational, written, and oral communication and presentation skills with proven experience writing and delivering presentations to members of the management team.

Responsibilities

• Develop new innovative VBP models for a range of provider types.
• Align scope of work with roadmap for new VBP model development.
• Analyze financial, utilization, and performance data to identify opportunities.
• Design and contribute to development of provider reporting packages.
• Partner with finance to conduct impact analysis and modeling for new VBP models.
• Collaborate with teams to operationalize and rollout new VBP models.
• Monitor VBP model performance KPIs and iterate as needed.
• Translate strategy into models that can be piloted and scaled across markets.

Skills

VBP design

Medicare/Medicaid

Data analysis

Matrixed environment

Communication

Problem solving

Presentation

Education

Bachelor's degree

Master's degree (Preferred)

Job description

Humana Inc. seeks a Value-Based Programs Lead for a remote role dedicated to strengthening value-based provider relationships and advancing Medicaid VBP initiatives. You will lead end-to-end operational support, model design, and reporting to improve quality and reduce total cost of care.

The candidate should have 5+ years in managed care operations and VBP design, with strong analytical and communication skills. Expect Mon-Fri EST hours and up to 10% travel.