Senior Value-Based Programs Professional

Value Based Market Support Senior Professional

Become a part of our caring community and help us put health first. The Value Based Market Support Senior Professional is responsible for providing comprehensive market support across assigned markets to ensure Value-Based Program (VBP) contract requirements and market objectives are achieved. The incumbent facilitates Business Review meetings with markets, offering performance updates, strategic consultation, and issue resolution related to VBP models. The position requires preparation and analysis of market data to drive effective decision-making and provides data-driven insights on the performance of active VBP models.

Key Responsibilities :

• Responsible for end to end market support for assigned Medicaid markets to ensure markets achieve their VBP contract requirements and market goals
• 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
• Prepare for QBR meetings, including reviewing and analyzing of 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
• Facilitate 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 VB 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 for operational gaps / barriers
• Lead on time new market implementations 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
• 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
• Drive new market implementation readiness review material development

Use your skills to make an impact

Required Qualifications :

Preferred Qualifications :

Additional Information :

WAH Internet Statement : To ensure Home or Hybrid Home / Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home / Office employees must meet the following criteria :

Benefits :

HireVue :

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

SSN Alert :

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana's secure website.

Travel :

While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours : 40

Pay Range : The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $78,400 - $107,800 per year. This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and / or individual performance.

Description of Benefits : Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides 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 and many other opportunities.

Application Deadline : 12-02-2025

About Us :

Humana Inc. (NYSE : HUM) is committed to putting health first for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer :

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training,