# Value-Based Programs Lead

**Company**: Humana Inc.
**Location**: Remote Nationwide
**Work arrangement**: remote
**Experience**: senior
**Job type**: full-time
**Salary**: $104,000 - $143,000 per year
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://humana.wd5.myworkdayjobs.com/en-US/Humana_External_Career_Site/job/Remote-Nationwide/Value-Based-Programs-Lead--VBP-Design-_R-436601?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/job/value-based-programs-lead-81211057-bfe/

## Description

Humana Healthy Horizons is seeking a Value-Based Programs Lead to support successful value-based provider relationships, focusing on improving the provider experience and achieving path-to-value goals.

The Value-Based Programs Lead will lead the operational support of specialty Medicaid value-based payment (VBP) models, aligning with segment strategy and goals. This role requires advanced technical knowledge and experience in VBP.

Key responsibilities:

- Develop innovative VBP models for various provider types, such as behavioral health, maternity, specialists, and social determinants of health

- Align scope of work with roadmap for new VBP model development to ensure compliance with Medicaid contractual requirements and RFP commitments

- Analyze financial, utilization, and performance data to identify opportunities for quality improvements and cost reductions

- Create VBP payment strategies and model designs, including payment model logic, performance metrics, and financial terms

- Design and contribute to the development of provider reporting packages

- Partner with the finance team to conduct impact analysis and modeling for new VBP models

- Collaborate with team members to operationalize and rollout new VBP models

- Monitor VBP model performance KPIs to identify opportunities for enhancement

Requirements:

- Bachelor's degree

- Minimum 5 years of experience in managed care operations, provider reimbursement and analytics, and value-based care

- 2+ years of direct experience designing, structuring, and implementing VBP strategies and models for specialty providers

- Experience using financial, utilization, quality, and performance data to design and model VBP arrangements

- Expertise in Medicare and/or Medicaid managed care

- Excellent interpersonal, organizational, written, and oral communication skills

Preferred qualifications:

- Master's degree

- Expertise in VBP financial modeling and impact analysis

- Direct experience working for a Medicaid managed care health plan

Additional information:

- Remote position

- Up to 10% travel for onsite meetings

- Typical workdays and hours: Monday – Friday; 8:00am – 5:00pm EST

- Pay range: $104,000 - $143,000 per year

- Eligible for a bonus incentive plan

Benefits:

- Medical, dental, and vision benefits

- 401(k) retirement savings plan

- Time off, including paid time off, company and personal holidays, paid parental and caregiver leave

- Short-term and long-term disability

- Life insurance

For more fresh new jobs, check out [yubhub.co](https://yubhub.co/).

## Skills

### Required
- value-based payment
- managed care operations
- provider reimbursement
- analytics
- Medicaid
- Medicare

### Nice to have
- VBP financial modeling
- impact analysis
- Medicaid managed care

---

Source: [Apply at humana.wd5.myworkdayjobs.com](https://humana.wd5.myworkdayjobs.com/en-US/Humana_External_Career_Site/job/Remote-Nationwide/Value-Based-Programs-Lead--VBP-Design-_R-436601?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)