Massachusetts Creative Jobs

MassHire Job Quest Logo

Job Information

Humana Director, Value-Based Strategies - Humana Care Solutions in Boston, Massachusetts


The Director, Value-Based Strategies - Humana Care Solutions will be a strategic leader of Humana's Direct Contracting Entity. The Director will develop and deploy the provider strategy for Humana's Direct Contracting Entity. The Director, Value-Based Strategy requires an in-depth understanding of value based provider relationships.


The Director, Value-Based Strategies - CMS Programs will develop and deploy Humana's provider network strategy for successful participation in CMS/CMMI Multi-Payor and Accountable Care Initiatives.

Leveraging a successful Medicare Advantage framework and robust provider relationships this role will allow Humana to assume financial risk for Original Medicare beneficiaries through participation in CMS' Direct Contracting Initiative. The Director will be responsible for creating a network of participating providers (PCP's) and preferred providers that will serve original Medicare beneficiaries. Additionally, the Director will collaboratively develop beneficiary benefit enhancement and engagement strategies that are supported by the provider network design. There will be a significant focus on value based provider relationships and the development of new and innovative payment models to support this program.

In support of this initiative, the Director will lead a team responsible for operations, provider/market engagement, and contracting and will report directly to the Associate VP of Humana Care Solutions. The leadership team of Humana Care Solutions will have P&L responsibility for approximately 50,000 original Medicare beneficiaries and $500M in revenue.

Educational and Professional Requirements:

  • Master's degree (preferred)

  • Bachelor's degree (required)

  • 5+ years health plan / provider experience

  • Experience building, administering, supporting value-based programs

  • 5+ years leadership experience

  • Financial acumen

  • Travel - 25%


Experience with CMS Advanced Alternative Payment Models and CMMI programs

Scheduled Weekly Hours