Johns Hopkins Health Plans
Manager of Value-Based Care Contracting
Johns Hopkins Health Plans, Baltimore, Maryland, United States, 21276
4 days ago Be among the first 25 applicants
Requisition #:658925 Location: Johns Hopkins Health Plans, Hanover, MD 21076 Category: Non-Clinical Professional Schedule: Day Shift Employment Type: Full Time
What Awaits You
Work-life balance - This is a hybrid role- must have ability to work in Hanover MD office on Wednesdays. Medical, Dental, and Vision Insurance. 403B Savings Plan w/employer contribution. Paid Time off & Paid holidays. Employee and Dependent Tuition assistance benefits. Health and wellness programs and MORE! 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. Equal Opportunity & Other Statements
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. Johns Hopkins Health System and its affiliates are an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.
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Work-life balance - This is a hybrid role- must have ability to work in Hanover MD office on Wednesdays. Medical, Dental, and Vision Insurance. 403B Savings Plan w/employer contribution. Paid Time off & Paid holidays. Employee and Dependent Tuition assistance benefits. Health and wellness programs and MORE! 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. Equal Opportunity & Other Statements
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. Johns Hopkins Health System and its affiliates are an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.
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