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The Value Based Market Support Senior Professional is responsible for providing comprehensive market support across assigned markets to ensure Value-Based Program (VBP) contract requirements and market objectives are achieved. The incumbent facilitates Business Review meetings with markets, offering performance updates, strategic consultation, and issue resolution related to VBP models. The position requires preparation and analysis of market data to drive effective decision-making and provides data-driven insights on the performance of active VBP models.

• Key Responsibilities:

• Responsible for end to end market support for assigned Medicaid markets to ensure markets achieve their VBP contract requirements and market goals
• Facilitate Quarterly Business Review Meetings (QBR) with assigned market leaders to provide updates on VBP model performance, answer questions and resolve issues, consult on VBP strategy and provider targets, and ensure timely decision making on VBP model rollout or changes
• Prepare for QBR meetings, including reviewing and analyzing of data, to ensure effective calls
• Consult with market on VBP strategy to ensure compliance with contractual requirements and market goals
• Provide data driven insights on market performance in each active VBP model
• Research and answer market or provider questions on VBP models
• Facilitate annual trainings for contracting, PR, PE, and other market staff on upcoming year VBP models and any changes
• Work with markets to facilitate timely decision making on new VBP models or changes to existing VBP models
• Coordinate internally with Medicaid VBP model design, contracting, and operations and analytics teams to prepare for and manage rollout of new VB models or changes to existing models
• Manage rollout of new VBP models or changes to VBP models, including coordinating with Medicaid VBP design, operations, and analytic colleagues and enterprise teams
• Convene matrixed operational partners to solve for operational gaps/barriers
• Lead on time new market implementations of year 1 Medicaid VBP models and related contract requirements, including developing and maintaining project plans, facilitating implementation meetings, driving decisions on VBP model payouts and metrics, and developing provider-facing and associate trainings
• Partner with cross functional and matrixed teams to drive key operational decisions, oversee implementation progress and milestones, and other project management functions.
• Support onboarding of market Network Optimization team, including their responsibilities for driving market VBP strategy and responsibilities of the corporate Medicaid VBP team
• Advise Medicaid market leaders on year 1 VBP model timing and rollout strategy
• Drive new market implementation readiness review material development  

Use your skills to make an impact
 

Required Qualifications:

• Bachelor’s Degree
• 3-5 years of experience at a health plan value-based care and/or provider engagement
• 3+ years experience in roles that involve reviewing and analyzing financial, quality, and utilization data and analytics
• 2+ years of project management experience
• Past experience in a role that required delivery of excellent customer service
• 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

Preferred Qualifications:

• Experience with Medicaid managed care

Additional Information

WAH Internet Statement

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 recommended; 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.

Benefits

Humana offe