Become a part of our caring community and help us put health first
The Senior Value-Based Programs Professional will work to drive Value Based Payment (VBP) strategy, implementation, and ongoing support for our Medicaid markets from beginning to end. This position will translate market VBP requirements into tactical plans that can be executed to ensure timely and successful new market launches including directing timelines, processes, and education material creation. The Senior Value-Based Programs Professional requires an in-depth understanding of how organization capabilities interrelate across the function or segment. The Senior Value-Based Programs Professional works independently, and often determines methods/approach to work and establishes own work priorities and timelines. The work consists of tasks that are moderately complex, requiring minimal instructions to achieve solutions.
Key Responsibilities
- Oversee the implementation of Medicaid VBP models in new markets to ensure timely and accurate delivery of health plan VBP operational functions, including market leaders, provider operations, and provider services areas
- Lead market implementation workgroups and meetings with senior market leadership beyond new market implementation, including identifying business owners and subject matter experts, identifying potential business or operational gaps and state nuances
- Partner with cross-functional and matrixed teams to drive key strategic and operational decisions, and oversee implementation progress and milestones
- Develop and maintain project plans, and other project management functions
- Convene matrixed operational partners to solve for operational gaps/barriers
- Support development of associate and provider education materials
- Drive process improvements and operational gap closure to improve efficiencies of VBP implementations
- Identify and solve problems that impact the achievement of results for the department and begin to influence the department’s strategy; problems and issues faced are complex and solved by drawing from prior experiences or knowledge of best practices; needs to be able to react quickly and adapt to changing department or team needs
- Build and maintain strong internal working relationships at all levels of the organization and across the enterprise; leverage these relationships in helping to drive innovation and effective operations for Humana Medicaid
Use your skills to make an impact
Required Qualifications
- Bachelors Degree
- 3+ years of experience in managed care operations, value-based care, and/or provider reimbursement and analytics
- 3+ years of project management experience and operating in a matrixed environment
- Understanding of Medicaid and/or Medicaid managed care
- Proven expertise in driving operational efficiencies and management of timelines and processes
- Highly adept at managing processes from concept to completion ensuring on-time, on-budget, and on-target results
- Ability to understand and analyze financial, utilization, and performance data
- Ability to identify, structure and solve business problems
- Excellent interpersonal, organizational, written, and oral communication and presentation skills with proven experience writing and delivering presentations to members of the management team.
Work-At-Home Requirements
To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
- Satellite, cellular and microwave connection can be used only if approved by leadership
- Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
- Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
- Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
Additional Information
Social Security Number Statement
Humana value's 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.
Interview Format
As part of our hiring process, we will be using an exciting interviewing technology provided by Hire Vue, a third-party vendor. This technology provides our team of recruiters and hiring managers an enhanced method for decision-making.
If you are selected to move forward from your application prescreen, you will receive an email correspondence inviting you to participate in a SMS Text Messaging interview. (please be sure to check your spam or junk folders often to ensure communication isn’t missed)
If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone to answer the questions provided. Expect this type of interview to last anywhere from 5-10 minutes. Your recorded interview(s) via text and/or pre-recorded voice will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviews.
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: 02-02-2025
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 veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, 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, including apprenticeship, at all levels of employment.
