Humana · 23 hours ago
Senior Value-Based Programs Professional
United States
Full-time
Remote
Mid, Senior Level
$78K/yr - $108K/yr
3+ years expHumana Inc. is committed to putting health first – for their teammates, customers, and company. The Senior Value-Based Programs Professional supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals.
Health CareHealth InsuranceInsuranceVenture Capital
Responsibilities
Administer new and existing innovative VBP models for range of provider types, such as primary care physicians, hospitals, behavioral health, maternity, and other specialists to move providers from volume to value
Analyze financial, utilization, and performance data to identify opportunities to drive improvements in quality and/or reductions in total cost of care
Scorecard creation and reconciliation of provider performance based on contractual terms
Analyze utilization data to reconcile provider disputes
Contribute to development and support of provider reporting packages to help providers understand their overall performance
Collaborate with cross functional and matrixed teams to operationalize and rollout new VBP models
Qualification
Required
3+ years of experience in managed care operations, provider reimbursement and analytics, and value-based care
In-depth knowledge of VBP model support including analyzing provider performance, reporting, and scorecard/reconciliation reporting
Understanding of Medicaid and/or Medicaid managed care
Ability to understand and analyze financial, utilization, and performance data
Ability to identify, structure and solve moderately complex business problems
Experience operating in a 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 be passionate about contributing to an organization focused on continuously improving consumer experiences
Preferred
Bachelor's Degree
Expertise in VBP financial modeling and impact analysis
Experience performing claims data analysis to inform VBP provider performance
Experience in SQL, SAS, PowerBI and/or Tableau
Benefits
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
Company
Humana
Humana is a health insurance provider for individuals, families, and businesses.
10001+ employees
H1B Sponsorship
Humana has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (282)
2024 (246)
2023 (284)
2022 (274)
2021 (212)
2020 (84)
Funding
Current Stage
Public CompanyTotal Funding
$13.07B2025-05-30Post Ipo Debt· $5B
2025-03-03Post Ipo Debt· $1.25B
2024-03-11Post Ipo Debt· $2.25B
Leadership Team
Jim Rechtin
CEO and President
Colin Drylie
Senior Vice President, Experience Transformation
Recent News
2026-01-13
2026-01-09
2026-01-07
Company data provided by crunchbase