Description

Humana Healthy Horizons is seeking a Value-Based Contract Writer (Value-Based Programs Lead) who will conduct all aspects of value-based payment (VBP) contracting including development, implementation, negotiation, and maintenance in alignment with segment strategy and goals. The Value-Based Contract Writer (Value-Based Programs Lead) requires in-depth understanding of VBP and the contracting process to support value-based programs.

Responsibilities

• Creates new contracts based on the VBP design and the business operational capabilities.
• Integrates contract changes as needed for existing VBP programs.
• Creates and oversees new contract approval process.
• Collaborates with cross-functional areas to understand and align on VBP programs.
• Communicates program overview including contract terms, payment structures, and payment rates to providers
• Assists with associate and provider educational materials.
• Negotiates program terms and analyzes financial impact of proposed terms.
• Manages repository of contracts and key contract terms to support VBP administration.
• Drives positive experiences and performance among participating providers.

Required Qualifications

• Bachelor's degree.
• 3 or more years of contracting experience for a healthcare company.
• 2 or more years of VBP contracting experience.
• Experience creating new contracts based on the VBP design and the business operational capabilities.
• Proficiency in analyzing, understanding, and communicating financial impact of contract terms, payment structures and reimbursement rates to providers.
• Experienced in negotiating managed care contracts with primary physician groups or other specialty providers.
• Proven contract preparation skills, with an in-depth knowledge of Medicaid VBP methodologies.
• Excellent written and verbal communication skills and experience presenting to varied audiences.
• Ability to manage multiple priorities in a fast-paced environment.
• Knowledge of Microsoft Office applications.

Work at Home Requirements

• 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.
• Associates 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 associates 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.

Preferred Qualifications

• Master's Degree.
• Experience with ACO/Risk Contracting.

Additional Information

• Workstyle: Remote
• Work Days & Hours: Monday – Friday; Eastern Standard Time (EST) with some flexibility.
• Travel: Up to 10% possibly outside of your state of residence.
• Vaccination Statement: 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.

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.

Social Security Task

Alert: Humana values personal identity protection. Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions to add the information into the application at Humana’s secure website.

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Scheduled Weekly Hours

40