Manager of Value Based Contracting

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Position Summary:

The Value-Based Program Contract Manager is responsible for overseeing the negotiation, execution, and management of value-based care agreements with healthcare providers, clinically integrated networks, health systems, and provider groups. This role ensures contracts are structured to align incentives, support quality improvement, control costs, and drive improved health outcomes for members and all lines of business (PPMCO, Medicare Advantage, USFHP and EHP). The manager collaborates with internal teams (legal, finance, operations, quality, analytics) and external providers to implement and monitor contract execution, contract performance, resolve disputes, and ensure compliance with regulatory and organizational requirements.

Experience: Work requires a minimum of 7 years' experience in provider relations in a managed care organization, with at least 3 of those years of experience in progressively more responsible management experience.

Education: Bachelor's degree; Master's Preferred

Contract Development & Negotiation

• Facilitates and leads provider negotiations for value-based contracts including pay-for-performance, shared savings, capitation, bundled payments, and hybrid models.

• Analyze VBC opportunities across lines of business to ensure competitive, compliant, and sustainable reimbursement arrangements.
• Supports the complete value based contracting cycle from planning, creating documents, negotiation and loading of executed arrangements.

Program Implementation & Administration

• Partner with internal finance, clinical, and operational teams to ensure successful implementation of provider agreements.
• Monitor provider performance against quality, cost, and utilization targets; develop strategies to support gap closure and performance improvement.
• Contribute to the development and execution of value-based contracting strategic initiatives and optimize medical cost management through effective program design.

Regulatory & Compliance Oversight

• Ensure contracts comply with applicable federal and state laws, including 42 C.F.R. 422, Medicaid managed care requirements, and TRICARE payment guidelines.
• Collaborate with compliance and legal teams to interpret evolving regulations and incorporate updates into contract strategy.

Financial & Data Analysis

• Conduct reimbursement, unit cost, and risk-sharing analytics to evaluate provider proposals and internal counteroffers.
• Develop models for provider incentive payments and ensure alignment with medical loss ratio (MLR) and budget targets.
• Partner with actuarial and data teams to assess financial impact and sustainability of value-based programs.

Provider & Stakeholder Engagement

• Serve as primary point of contact for provider partners regarding value-based arrangements.
• Build and maintain strong provider relationships, fostering collaboration on quality improvement and cost containment initiatives.
• Represent the organization in external meetings, joint operating committees, and steering groups.

Who we are:

Johns Hopkins Health Plans (JHHP) is the managed care and health services business of Johns Hopkins Medicine. JHHP is a $3B business serving over 500,000 active members with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHP is a leader in provider-sponsored health plans and is poised for future growth.

Many organizations talk about transforming the future of healthcare, at Johns Hopkins Health Plans, we are setting the pace for change within the healthcare industry. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for our members and the communities we serve.

Salary Range: Minimum 44.98/hour - Maximum 78.73/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility.

In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority.

We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices.

Johns Hopkins Health System and its affiliates are drug-free workplace employers.