The Value-Based Programs Lead 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. This role will report to the Associate Director, Value-Based Programs.
CenterWell is seeking a Value Based Programs Analyst to support its growing Accountable Care Organization (ACO) and Original Medicare programs contracted through the Centers for Medicare & Medicaid Services (CMS). This role is responsible for producing accurate, timely reporting and performance insights for various ACO models (MSSP, LEAD) and other CMS initiatives (e.g., ACCESS). Under the direction of ACO leadership, the analyst will contribute to ACO performance monitoring, data validation, business process automation, and analytical insights that support clinical, operational, and financial decision-making. This position partners closely with Clinical, Operations, Data, and Finance teams to translate complex healthcare data into actionable intelligence and identify opportunities to improve quality outcomes and cost performance. The ideal candidate brings strong analytical skills, experience working with Medicare and ACO-related data, and a solid understanding of value-based care concepts, including provider attribution, utilization, quality, and total cost of care. This role requires the ability to work with large, complex datasets spanning provider, clinical, and member domains and to communicate insights clearly to both technical and non-technical stakeholders.
ESSENTIAL DUTIES:
1. Produce and maintain ACO reporting package including performance reporting for ACO Medicare programs (e.g., MSSP, LEAD, ACCESS, etc.)
2. Analyze ACO datasets and claims files to identify trends and compare against CMS benchmarks and targets
3. Partner with Operations, Finance, and Clinical teams to translate data findings into actionable insights and performance improvement opportunities
4. Support financial and quality analyses related to shared savings, total cost of care, utilization trends, and quality measure performance
5. Validate data accuracy and completeness across multiple data sources; ensure integrity of ACO program data; work with Data Analytics team on issue resolution
6. Partner with Data Analytics team to develop dashboards and visualizations to communicate trends, risks, and opportunities for ACO leadership and key stakeholders
7. Leverage data to automate business processes supporting care coordination, attribution / alignment, network management, and other operational workflows
8. Possesses strong SQL skills / ability to query data; has experience working with data editing environment, Snowflake
9. Stay current on CMS program requirements, ACO regulations, and value-based care metrics impacting Original Medicare programs
10. Coordinate the timely production and submission of reports per the specifications and timetables established by external bodies and internal leadership. Ensure reports are distributed or are available to stakeholders, teams, committees, etc. that would likely benefit from the information.
11. Advise on design of meaningful, insightful, compelling data formats for the effective communication of information, customized to target audience(s).
12. Present information on conference calls, web meetings, in-person meetings, and other group communication methods.
STANDARD REQUIREMENTS:
1. Supports the Mission, Value and Vision of CenterWell
2. Exhibits excellent customer service skills and behaviors toward internal and external customers and co-workers
3. Supports and participates in a collaborative team-oriented environment – cooperates and works together with all co-workers, plans and completes job duties, uses appropriate communications in sensitive and emotional situations and follows up as appropriate regarding reported complaints, problems and concerns.
4. Supports, cooperates with and demonstrates safe work practices and attitudes, follows safety rules – including universal precautions - reports and prevents/corrects unsafe conditions and behaviors, and participates in organizational and departmental safety programs.
5. Completes all required compliance standards that may be department specific and/or identified by the organization.
STANDARD QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.
Required Qualifications:
Preferred Qualifications:
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 yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
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.
About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient’s well-being.About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer at CenterWell.com.
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 protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with 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.
CenterWell is a leading health care services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high quality health care that is accessible, comprehensive, and, most of all, personalized. As the largest provider of senior-focused primary care, one of the leading providers of home health care, and a leading integrated home delivery, specialty, hospice, and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc.
