Value-Based Programs Lead (Data and Analytics)

Appcast

$104K — $143K *
US-AnywhereRemote in United States
Healthcare
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • 8+ years of experience in Database Management Systems, proficient in SQL or SAS
  • 8+ years of healthcare or managed care experience
  • 8+ years of data analysis and extraction skills
  • 3+ years in Value-Based Care or CMS/Managed Care Hospital Payment Strategies
  • 3+ years of utilizing standardized Quality Metrics from organizations like AHRQ, NCQA, or NQF
  • Experience with PowerPlatform Tools and MS Suite, particularly Excel
  • Strong verbal and written communication abilities

Responsibilities

  • Develop and scale a data framework for hospital quality measures
  • Synthesize various data sources into a unified operational database
  • Monitor and maintain operational logic for the program
  • Ensure program integrity and proper payment protocols
  • Lead the design and logic creation for program measures
  • Oversee the established measure management process
  • Advise leadership and coordinate tasks with peer organizations effectively

Benefits

  • Comprehensive medical, dental, and vision coverage
  • 401(k) retirement savings plan
  • Generous paid time off, including personal holidays and volunteer days
  • Paid parental and caregiver leave
  • Disability insurance options
  • Life insurance and wellness programs
Full Job Description
The Value-Based Programs Lead (Data and Analytics) supports successful value-based provider relationships with a focus on improving the provider experience and achieving path-to-value goals. The Value-Based Programs Lead provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience.

The Value-Based Programs Lead (Data and Analytics) works with senior executives to develop and drive segment or enterprise-wide functional strategies. Advises one or more areas, programs or functions and provides recommendations to senior executives on matters of significance, and as an advanced subject matter expert competent to work at very high levels in multiple knowledge and functional areas across the enterprise.

The Value-Based Programs Lead job constitutes creating and implementing the program’s data framework and developing and managing ongoing data creation and maintenance for a newly developed Hospital-focused Value-based initiative, including measure development/creation. The associate will:

  • Develops and implements a scalable data framework for hospital-focused quality measures for enterprise-consumption
  • Develops and implements processes and procedures that synthesize multiple disparate data sources from across the enterprise into a single source for program operations and analytics
  • Develops, monitors, and maintains program operational logic
  • Develops processes that ensure proper program and payment integrity
  • Leads program measure design and logic development for the initiative
  • Develops and leads established measure management process
  • Partners with and advise leadership and key stakeholders; operate independently to ensure deadlines are met by effectively planning, organizing, prioritizing, and coordinating with peer organizations


Use your skills to make an impact

Required Qualifications

  • 8+ years of Database Management Systems experience (must have significant experience reading/writing/manipulating SQL or SAS)
  • 8+ years of Healthcare or managed care experience
  • 8+ years of data analysis and data extraction analysis experience
  • 3+ years of experience in Value-Based Care or CMS/Managed Care Hospital Payment Strategies
  • 3+ years of working with standardized Quality Metrics from entities like AHRQ, NCQA, or NQF
  • Experience utilizing PowerPlatform Tools and MS Suite particularly Excel
  • Clear oral and written communication skills

Preferred Qualifications

  • Bachelor's Degree
  • Experience with Databricks
  • Experience working with Humana’s EDW and Quality Data
  • Experience working with and understanding technical resources & specifications related to Quality Measures
  • Experience building and maintaining Quality Measure sets

Additional Experience

This role is "remote/work at home" and can be based anywhere in the United States.

Work-At-Home Requirements

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.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The 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.$104,000 - $143,000 per year


 

This 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: 06-04-2026

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