Vice President – Value-Based Care Performance

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as the accountable executive for the financial and operational outcomes of client portfolios, focusing on global risk, shared savings, and pay-for-performance frameworks.

• Strategically implement and deploy IKS solutions, including business intelligence, risk stratification, actuarial analytics, agentic engagement, care gap closure, HCC coding, and care management.

• Enhance revenue performance by optimizing risk adjustment programs, quality measures (such as HEDIS, CAHPS, MIPS), and patient engagement initiatives.

• Analyze spending trends in relation to contract and market performance, identify drivers of underperformance, and spearhead high-impact initiatives to reduce unnecessary medical, behavioral, and pharmacy utilization.

• Operationalize the redesign of care models and workflow transformation through active engagement in client change management processes.

• Assist in structuring and negotiating complex risk contracts with payers and risk-bearing entities, while ensuring diligent downstream governance.

• Enhance network strategy by advising on high-value provider alignment, provider incentives, tiering strategies, and preferred specialists and facilities.

⛳️ Requirements

• Over 12 years of progressive leadership experience in diverse value-based care organizations (e.g., risk-bearing provider group, MSO, ACO, health system, payvider).

• Proficient in risk models applicable to both Medicare (Medicare Advantage, ACO) and Medicaid.

• Experience with commercial risk and/or rural healthcare delivery systems is an advantage.

• Direct understanding of inpatient and outpatient care delivery environments to effectively influence change transformation.

• P&L accountability with a proven history of translating strategy into quantifiable financial results.

• Strong executive presence and communication abilities, capable of influencing cross-functional stakeholders in executive leadership teams as well as lower levels of the organization.

• Demonstrated analytical and operational skills to effectively translate complex claims, clinical, and financial data into actionable strategies.

• Self-motivated with a proactive approach and disciplined self-accountability within intricate organizational structures.

• Willingness to travel to client locations, fostering engagement and driving local execution (approximately 40% travel).

🏝️ Benefits

• Healthcare

• 401(k)

• Paid time off