About the Role

The Value-Based Program Lead plays a crucial role in supporting Value-Based Programs (VBPs) across assigned markets. This position ensures that VBPs meet contract requirements and achieve market objectives. The Lead will manage and facilitate Business Review meetings with markets, providing performance updates, strategic advice, and issue resolution for VBP models. A key aspect of this role involves preparing and analyzing market data to inform decision-making and offer data-driven insights into the performance of active VBP models.

Key Responsibilities:

Market Support: Manage and oversee the end-to-end market support for assigned Medicaid markets to ensure they achieve their VBP contract requirements and market goals.
Business Reviews: Manage and facilitate Quarterly Business Review (QBR) Meetings with assigned market leaders. This includes providing updates on VBP model performance, addressing questions, resolving issues, consulting on VBP strategy and provider targets, and ensuring timely decisions on VBP model rollout or changes.
Implementation Management: Effectively manage and facilitate the implementation of Year 1 Medicaid VBP models and related contract requirements in new markets. This involves developing and maintaining project plans, facilitating implementation meetings, driving decisions on VBP model payouts and metrics, and developing training materials for providers and associates.
Data Analysis & Insights: Prepare for QBR meetings by reviewing and analyzing data to ensure effective discussions. Provide data-driven insights into market performance for each active VBP model.
Strategic Consultation: Consult with markets on VBP strategy to ensure compliance with contractual requirements and market goals.
Training & Rollout: Oversee the rollout of annual trainings for contracting, PR, PE, and other market staff on upcoming VBP models and any changes. Work with markets to facilitate timely decision-making on new or modified VBP models.
Internal Coordination: Coordinate with internal Medicaid VBP model design, contracting, operations, and analytics teams for the rollout of new or changed VBP models. Convene matrixed operational partners to address and resolve operational gaps or barriers.
Project Management: Partner with cross-functional and matrixed teams to drive key operational decisions, oversee implementation progress and milestones, and manage other project functions.
Onboarding Support: Support the onboarding of the market Network Optimization team, clarifying their responsibilities in driving market VBP strategy and the role of the corporate Medicaid VBP team.
Guidance: Advise Medicaid market leaders on Year 1 VBP model timing and rollout strategy.

Required Qualifications

Bachelor's degree.
3-5 years of experience working at a health plan in value-based care and/or provider engagement.
3+ years of highly data-driven analytics experience, with a consistent focus on deeply analyzing and interpreting financial, quality, and utilization data to inform decision-making and drive outcomes.
2+ years of project management experience.
2+ years of progressive leadership experience, including hiring, training, and managing associates.
Highly adept at managing processes from concept to completion, ensuring on-time, on-budget, and on-target results.
Ability to identify, structure, and solve business problems.
Excellent interpersonal, organizational, written, and oral communication and presentation skills.

Additional Information

Workstyle: This is a remote position.
Travel: May require up to 10% travel for onsite meetings.
Work Schedule: Monday - Friday, 8:00 AM - 5:00 PM Eastern Standard Time (EST).
Direct Reports: 2 associates.

WAH Internet Statement:

To ensure effective remote work, employees must meet the following internet criteria:

Minimum download speed of 25 Mbps and upload speed of 10 Mbps. Wired cable or DSL connection is suggested.
Satellite, cellular, and microwave connections require leadership approval.
Employees in California, Illinois, Montana, or South Dakota will receive a bi-weekly internet expense payment.
Humana will provide necessary telephone equipment.
Work from a dedicated, interruption-free space to protect member PHI / HIPAA information.

Interview Format:

This role utilizes HireVue, an interviewing technology, to enhance the hiring process.

Scheduled Weekly Hours:

Pay Range:

$104,000 - $143,000 per year. This is a good faith estimate; actual pay may vary based on location, skills, experience, and education. This job is eligible for a bonus incentive plan based on company and/or individual performance.

Description of Benefits:

Humana offers competitive benefits supporting whole-person well-being, including:

Medical, dental, and vision benefits
401(k) retirement savings plan
Time off (paid time off, holidays, volunteer time off, paid parental/caregiver leave)
Short-term and long-term disability
Life insurance
And more.

Application Deadline:

08-10-2026

About Humana

Humana Inc. is a leading U.S. healthcare company focused on making it easier for millions of people to achieve their best health through its insurance services and CenterWell healthcare services. We serve individuals with Medicare and Medicaid, families, military personnel, and communities, aiming to improve quality of life.

Equal Opportunity Employer

Humana is committed to equal employment opportunities and affirmative action. We do not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability, or protected veteran status. All employment decisions are based on valid job requirements. Humana complies with applicable federal civil rights laws and provides free language interpreter services. Accessibility resources can be found at https://www.humana.com/legal/accessibility-resources?source=Humana_Website.

Value-Based Programs Lead

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