Senior Value-Based Programs Professional - Remote, US

Description

The Senior Value-Based Programs Professional supports successful value-based provider relationships in the Humana Healthy Horizons in Ohio market with a focus on improving the provider experience and achieving path-to-value goals. The Senior Value-Based Programs Professional works on problems of diverse scope and complexity ranging from moderate to substantial. The Senior Value-Based Programs professional will play a key role in the implementation and support of key value-based care programs in the Ohio Medicaid Market. This role will be focused on the implementation and administration of significant VBC relationships in the Ohio Medicaid market.

Responsibilities

The Senior Value-Based Programs Professional advises executives to develop functional strategies (often segment specific) on matters of significance. Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.

• Manages the operational feasibility review and implementation of Ohio-specific VBC contracts, such as the Ohio Pediatric ACO contracts.
• Oversees and coordinates the VBC implementation pipeline for Humana Medicaid National programs in Ohio.
• Develops policies and process to provide governance of ODM-required VBC programs.
• Advises Ohio Network executive leadership on VBC progress for Humana Healthy Horizons Ohio through the development of scorecards and executive summaries.
• Develops tools and processes for Value Based Programs governance for Humana Health Horizons Ohio.

Required Qualifications

• Bachelor's Degree or equivalent experience.
• Minimum two (2) years of experience in valued-based care, network contracting, network operations and/or network development.
• Intermediate experience in MS Office programs.
• Excellent organizational skills and attention to details.
• Proven expertise in driving management of timelines and processes.
• Ability to identify, structure and solve complex business problems.
• Experience operating in matrixed environment.
• Excellent interpersonal, organizational, written, and oral communication and presentation skills with proven experience writing and delivering presentations to members of the management team.
• Must have the ability to provide a high speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
• A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required.
• Satellite and Wireless Internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters. Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field.

Preferred Qualifications

• Master's Degree.
• Experience working with the Ohio Department of Medicaid (ODM) contracting requirements.
• Understanding of Ohio Medicaid contractual requirements, Ohio Administrative and Revised Codes, and provider landscape.
• Expertise in value based payment models.
• Knowledge of Humana's internal policies, procedures and systems.

Additional Information

• Travel: Up to 10%

Interview Format

As part of our hiring process, we will be using an exciting interviewing technology provided by Modern Hire, 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 Interview and/or an SMS Text Messaging interview. If participating in a pre-recorded interview, you will respond to a set of interview questions via your phone. You should anticipate this interview to take approximately 10-15 minutes.

If participating in a SMS Text interview, you will be asked a series of questions to which you will be using your cell phone or computer 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