Value-Based Programs Lead

Humana

1d • Remote

About The Position

The Value-Based Program Lead leads VBP market support across assigned markets to ensure the Value-Based Program (VBP) achieves contract requirements and market objectives. The Value-Based Program Lead will manage and facilitate Business Review meetings with markets, offering performance updates, strategic consultation, and issue resolution related to VBP models. This position requires preparation and analysis of market data to drive effective decision-making and provides data driven insights into the performance of active VBP models. Manage and oversee the end-to-end market support for assigned Medicaid markets to ensure markets achieve their VBP contract requirements and market goals Manage and facilitate Quarterly Business Review Meetings (QBR) with assigned market leaders to provide updates on VBP model performance, answer questions and resolve issues, consult on VBP strategy and provider targets, and ensure timely decision making on VBP model rollout or changes. Effectively manage and facilitate new market VBP implementation of year 1 Medicaid VBP models and related contract requirements, including developing and maintaining project plans, facilitating implementation meetings, driving decisions on VBP model payouts and metrics, and developing provider-facing and associate trainings. Prepare for QBR meetings, including reviewing and analyzing data, to ensure effective calls. Consult with market on VBP strategy to ensure compliance with contractual requirements and market goals. Provide data-driven insights on market performance in each active VBP model. Research and answer market or provider questions on VBP models. Oversee the rollout of annual trainings for contracting, PR, PE, and other market staff on upcoming year VBP models and any changes. Work with markets to facilitate timely decision-making on new VBP models or changes to existing VBP models. Coordinate internally with Medicaid VBP model design, contracting, and operations and analytics teams to prepare for and manage rollout of new VBP models or changes to existing models. Manage rollout of new VBP models or changes to VBP models, including coordinating with Medicaid VBP design, operations, and analytic colleagues and enterprise teams. Convene matrixed operational partners to solve operational gaps/barriers. Partner with cross functional and matrixed teams to drive key operational decisions, oversee implementation progress and milestones, and other project management functions. Support onboarding of market Network Optimization team, including their responsibilities for driving market VBP strategy and responsibilities of the corporate Medicaid VBP team. Advise Medicaid market leaders on year 1 VBP model timing and rollout strategy.

Requirements

• Bachelor's degree.
• 3 - 5 years of experience working at a health plan in value-based care and/or provider engagement.
• 3 or more years of highly data-driven analytics experience, with a consistent focus on deeply analyzing and interpreting financial, quality, and utilization data to inform decision-making and drive outcomes.
• 2 or more years of project management experience.
• 2 or more years of progressive leadership experience hiring, training, and managing associates.
• Highly adept at managing processes from concept to completion ensuring on-time, on-budget, and on-target results.
• Ability to identify, structure and solve business problems.
• Excellent interpersonal, organizational, written, and oral communication and presentation skills.

Responsibilities

• Manage and oversee the end-to-end market support for assigned Medicaid markets to ensure markets achieve their VBP contract requirements and market goals
• Manage and facilitate Quarterly Business Review Meetings (QBR) with assigned market leaders to provide updates on VBP model performance, answer questions and resolve issues, consult on VBP strategy and provider targets, and ensure timely decision making on VBP model rollout or changes.
• Effectively manage and facilitate new market VBP implementation of year 1 Medicaid VBP models and related contract requirements, including developing and maintaining project plans, facilitating implementation meetings, driving decisions on VBP model payouts and metrics, and developing provider-facing and associate trainings.
• Prepare for QBR meetings, including reviewing and analyzing data, to ensure effective calls.
• Consult with market on VBP strategy to ensure compliance with contractual requirements and market goals.
• Provide data-driven insights on market performance in each active VBP model.
• Research and answer market or provider questions on VBP models.
• Oversee the rollout of annual trainings for contracting, PR, PE, and other market staff on upcoming year VBP models and any changes.
• Work with markets to facilitate timely decision-making on new VBP models or changes to existing VBP models.
• Coordinate internally with Medicaid VBP model design, contracting, and operations and analytics teams to prepare for and manage rollout of new VBP models or changes to existing models.
• Manage rollout of new VBP models or changes to VBP models, including coordinating with Medicaid VBP design, operations, and analytic colleagues and enterprise teams.
• Convene matrixed operational partners to solve operational gaps/barriers.
• Partner with cross functional and matrixed teams to drive key operational decisions, oversee implementation progress and milestones, and other project management functions.
• Support onboarding of market Network Optimization team, including their responsibilities for driving market VBP strategy and responsibilities of the corporate Medicaid VBP team.
• Advise Medicaid market leaders on year 1 VBP model timing and rollout strategy.

Benefits

• medical
• dental
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level