Value Based Programs Specialty Care Lead

Humana • Mansfield, TX

238d • $104,000 - $143,000 • Remote

About The Position

The Value-Based Programs Specialty Care Lead supports the creation of complex value-based programs. The Value-Based Programs Lead provides strategic advice and guidance to functional team(s) related to value-based vendor and specialty deals. In supporting Humana's Value-Based Strategies organization, the Value-Based (VB) Programs Lead will be accountable for the development of new innovative VB provider payment models designed to promote improved quality, outcomes, and cost of care. Primary responsibilities of this role will be the evaluation of VB Payment Model efficacy and scalability as we seek to broaden our core VB Program portfolio. The ultimate goal is to lay the foundation with providers for additional partnerships that help create the most integrated and value-based relationships in the industry.

Requirements

• 5+ years of experience in a corporate strategy role or financial leadership role
• 3+ years of healthcare contracting experience
• Experience in managing the strategic planning cycle for a large organization with cross-functional engagement and prioritization
• Excellent written and verbal communication skills
• Problem-solving leadership skills with limited oversight
• Flexible, dynamic personality who works well in a team environment

Nice To Haves

• BA/BS degree in Accounting, Finance, or Mathematics
• MBA or graduate degree in a management field
• Experience executing complex strategic and operational initiatives
• Clinical experience or certification
• Knowledge of Humana's internal policies, procedures and systems

Responsibilities

• Develops, designs, and implements new payment arrangements that improve quality and the member experience
• Negotiates and implements specialty physician contracts
• Designs complex mathematical models to help drive contractual decisions
• Works with senior executives and various program owners to develop and drive value-based contracts for vendor and specialty programs
• Becomes an expert in the data available from disparate sources and uses this information to conduct business analyses and recommend implementation and execution plans
• Conducts complex financial and other data analysis and makes recommendations (cost-benefit, market recommendations, strategy pro-forma, and impact analysis) that significantly impact the market operations
• Assesses emerging trends, develops formulas to measure and manage initiative success
• Manages the development and review/measurement of key business priorities

Benefits

• Medical Benefits
• Dental Benefits
• Vision Benefits
• Health Savings Accounts
• Flex Spending Accounts
• Life Insurance
• 401(k)
• PTO including 9 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree