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The Director, Value-Based Programs supports successful value-based provider relationships with a focus on improving the provider experience and achieving The Director, National Value-Based Provider Performance and Strategy supports successful national and market level value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The position requires an in-depth understanding of how organization capabilities interrelate across the function or segment.The Director, National Value-Based Provider Performance and Strategy’s decisions are typically related to the implementation of new/updated programs or large-scale projects for the enterprise, along with creating and/or supporting technical/operational procedures and processes, strategic plans, goals and objectives, that are focused on improving value-based provider performance.
This role will be directly responsible for two key areas: 1) Strategic direction, ongoing operational oversight, and contract negotiation support of Humana’s National Value-based Provider groups (including ways to drive and maintain success with these partners) and 2) creating strategies, trainings and supporting tools and materials that are utilized by market Vice Presidents of Provider Engagement and Provider Engagement Executives to improve the performance of Value-based Providers.
Responsibilities include:
- Responsible for the strategic development and implementation of operations, contract negotiations support, business owner of Humana’s value-based performance improvement toolkit (Provider MOIC), market engagement and provider education, and cross functional departmental leadership regarding Value-Based provider agreements across the enterprise.
- Responsible for leading and overseeing national relationship management of key multi state value-based provider partners. Leads expansion of these key partners to support market level primary care strategies and assist with supply chain mitigation initiatives.
- Work collaboratively with senior leadership and multiple enterprise departments to drive market blueprint and supply chain process. Consolidate complex market strategies into cohesive plan to present to senior leaders.
- Ensures the resolution of the development, expansion, and overall success of Key Performance Indicators and Best Practices
- Develops and maintains market tools and resources to support Value Based relationships
- Support expansion and usage of Population Insights Compass by our National Value Based provider partners to assist in improved provider performance and member outcomes.
- Manage a team of 5-10 associates.
Use your skills to make an impact
Required Qualifications:
- Minimum 5 years’ experience working with value-based providers
- Experience leading value-based contract negotiations
- Deep understanding of key value-based financial components including revenue drivers, expense (DOFR) components, benefit and sales process.
- 2+ years' experience leading/managing teams
- Experience presenting to senior leadership.
- Experience working successfully in a matrix environment
- Strong project management experience on mid to large scale projects.
- Flexible, dynamic personality who works well in a team environment.
Preferred Qualifications:
- Bachelor’s Degree
- Data and analytics experience interpreting value based KPI metrics to improve provider performance
- Service Fund knowledge
- Market operations experience
Additional Information
This role is "remote/work at home" and can be based anywhere in the United States.
Work at Home Information
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:
- At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested
- Satellite, cellular and microwave connection can be used only if approved by leadership
- Employees 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 employees 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
Scheduled Weekly Hours40
Pay RangeThe 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.$150,000 - $206,300 per yearThis 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: 02-18-2025
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.
