[Hiring] Value-Based Programs Lead @Humana

Role Description

The Value-Based Programs Lead (Medicaid Strategy) supports successful value-based provider relationships with a focus on improving the provider's experience and achieving path-to-value goals. The Value-Based Programs Lead provides strategic advice and guidance to functional team(s).

The Value-Based Programs Lead (Medicaid Strategy) will advise senior leadership on Medicaid segment strategy that delivers upon segment cost, quality, and provider advancement goals. You will also support Medicaid Request for Proposals (RFPs) by developing market-specific VB strategy, commitments, and provider partnerships that contribute to winning proposals that expand existing and new business.

Key Responsibilities:

• Use data to identify and develop solutions for opportunities to advance the Medicaid segment's VBP strategy and achieve quality, trend, and contractual priorities.
• Lead VBP strategy development for 2-3 growth market Requests for Proposal (RFPs) per year.
• Conduct competitor research and gather provider insights, aligning VB models with population health and quality priorities at Humana.
• Identify partnership opportunities to strengthen proposal outcomes.
• Collaborate with Medicaid Network and Network Strategy team to advise and support negotiations for VB provider contractual commitments ahead of RFP submissions.
• Be the subject matter expert (SME) for VB strategy in Medicaid RFPs.
• Evaluate and make recommendations on designing new, re-designing existing, and sunsetting VB models based on available ROI/outcome, quality, and trend data.
• Support VB Solution team's annual strategic planning process by contributing market insights and data-driven recommendations.
• Conduct competitor research using previous RFPs and other industry sources.
• Monitor national VB care trends/research and communicate relevant information to peers and stakeholders.
• Lead VBP Annual Report content development.
• Other responsibilities as assigned.

Qualifications

• Bachelor's degree.
• Five (5) or more years of experience in value-based care, preferably with a health plan.
• Three (3) or more years of experience in a strategy advancement role.
• Three (3) or more years of highly data-driven analytics experience.
• Demonstrated ability to develop and execute strategies from concept through completion.
• Ability to identify, structure, and solve complex business problems.
• Proven ability to communicate effectively with leadership teams.

Requirements

• Experience with Medicaid managed care.

Benefits

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave).
• Short-term and long-term disability.
• Life insurance.
• Many other opportunities.

Company Description

Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health.