Value Based Programs Specialty Care Lead
Remote US, United States
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.
- Develops, designs, and implements new payment arrangements that improve quality and the member experience
- 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 use 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
- Designs complex mathematical models to help drive contractual decisions
- Manages the development and review/measurement of key business priorities
- This is an individual contributor role
- This role reports to the Associate Vice President of Value Based Strategies
In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:
- 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
- And more
Use your skills to make an impact
Required Qualifications:
- 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
Preferred Qualifications:
- 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
Additional Information
Work at Home/Remote Requirements
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 to support Humana applications, per associate.
- Wireless, Wired Cable or DSL connection is suggested.
- Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.)
- Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. 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
Our Hiring Process
As part of our hiring process, we will be using an exciting interviewing technology provided by HireVue, 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 correspondence inviting you to participate in a pre-recorded Voice, Text Messaging, and/or Video Interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone or computer. You should anticipate this interview to take approximately 10-15 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.
If you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.
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Scheduled Weekly Hours
40Pay 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.
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: 04-08-2025About 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.
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California Dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Illinois Montana Remote US South Dakota Work-At-Home Work-At-Home Requirements Work from a dedicated space Work from a dedicated space lacking ongoing interruptions Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Work from Home in the state of California, Illinois, Montana, or South Dakota
Benefits/Perks401(k) 401k retirement 401k Retirement Savings Bonus Incentive Bonus incentive plan Caregiving leave Caring community Competitive benefits Dental Dental benefits Disability Flex spending accounts Healthcare decisions Health first Health Savings Accounts Holidays Life Life Insurance Medical Medical benefits Paid holidays Paid parental and caregiver leave Paid Time Off Parental and Caregiver Leave Parental leave Personal holidays PTO Smart healthcare decisions Support whole-person well-being Time off Vision Vision Benefits Volunteer time Volunteer time off Weekly well-being time Well-being time Whole-person well-being Work-At-Home Work From Home
Tasks- Analysis
- Communication
- Conduct financial analysis
- Data Analysis
- Design payment arrangements
- Develop value-based programs
- Evaluate payment model efficacy
- Manage strategic planning
- Planning
- Research
- Strategic Planning
- Training
Accounting Analysis BI Business Clinical Clinical Experience Communication Compensation Computer Contracting Corporate strategy Data Data analysis Dental Education Evaluation Finance Financial leadership Go Healthcare Healthcare contracting Healthcare services HIPAA HireVue Implementation Initiative Insurance Interviewing IT Leadership Life Insurance Management Mathematical Mathematical modeling Mathematics Medicaid Medicare Operations Organization Oversight Planning Policy Prioritization Problem-solving Recruitment Research Strategic planning Strategy Support Teams Teamwork Technology Training VB Verbal communication Vision Wellness
Experience5 years
EducationAccounting Associate Associates B.A. B.S. Business Communication Data Analysis Education Finance Graduate Graduate Degree Healthcare Higher IT Management Mathematics MBA Operations
Certifications TimezonesAmerica/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9