Principal Value-Based Care Operations Advisor

This is a fully remote position, open to applicants in Kentucky, +4 more states.

📋 Description

• Oversee the comprehensive operational design of value-based care initiatives, which include shared savings, downside risk, and alternative payment models.

• Convert strategic program goals into operational workflows, governance frameworks, and execution strategies.

• Identify operational deficiencies in contracting, attribution, performance measurement, reporting, and financial settlement processes.

• Collaborate with clinical, finance, actuarial, analytics, and network teams to ensure alignment between program design and operational execution.

• Assist in the development and enhancement of value-based care operating models and cross-functional procedures.

• Analyze program performance indicators and suggest enhancements to improve outcomes and financial viability.

• Facilitate the implementation of new reimbursement models and strategies for provider partnerships.

• Lead intricate cross-functional projects with enterprise stakeholders and external partners.

• Support provider engagement initiatives by ensuring operational readiness and establishing clear performance expectations.

• Create repeatable processes and controls to enhance program scalability and measurement accuracy.

• Recognize execution risks and formulate mitigation strategies.

• Present operational insights, performance ramifications, and strategic recommendations to senior leadership.

• Act as a subject matter expert in value-based care operations and enterprise transformation projects.

• Mentor and support team members involved in the delivery of value-based care programs.

⛳️ Requirements

• A bachelor’s degree or an advanced degree in healthcare administration, business, public health, or a related field, or at least 10 years of directly relevant healthcare experience in lieu of a degree.

• Over 8 years of experience in healthcare operations, value-based care programs, payer-provider strategies, or healthcare consulting.

• Proven experience in supporting or managing value-based care models, including total cost of care or risk-sharing arrangements.

• Background in clinical operations, finance, analytics, and network/provider engagement.

• Strong grasp of healthcare reimbursement and performance measurement concepts.

• Experience operationalizing Medicare Advantage and Commercial VBC programs is preferred.

• Familiarity with shared savings reconciliation or financial settlement processes is preferred.

• Understanding of attribution methodologies, performance measurement frameworks, and population health analytics is preferred.

• Experience working with payer organizations or integrated delivery systems is preferred.

• Background in consulting or enterprise transformation focused on healthcare operating model design is preferred.

• Authorization to work in the United States.

🏝️ Benefits

• Annual Incentive Bonus based on achievement of corporate goals and individual performance.

• 401(k) plan with employer matching.

• Paid Time Off (PTO).

• Competitive health benefits.

• Wellness programs.

• Reasonable accommodations for applicants with disabilities.