Vice President, Value-Based Care Performance

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

📋 Description

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

• Strategically implement IKS solutions, which include 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 strategies.

• Examine spending trends against contractual obligations and market performance, identify factors leading to underperformance, and spearhead high-impact initiatives to reduce unnecessary medical, behavioral, and pharmacy utilization.

• Operationalize the redesign of care models and transform workflows by engaging comprehensively in client change management processes.

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

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

⛳️ Requirements

• Over 12 years of progressive leadership experience within various value-based care organizations.

• In-depth knowledge of risk models applicable to both Medicare and Medicaid.

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

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

• P&L accountability with a proven history of successfully translating strategy into measurable financial outcomes.

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

• Demonstrated analytical and operational skills, enabling the translation of complex claims, clinical, and financial data into actionable strategies.

• Self-motivated individual with a proactive approach and disciplined accountability within complex organizational structures.

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

• Bachelor's Degree is required; Master's degree is preferred.

🏝️ Benefits

• Healthcare coverage.

• 401(k) plan.

• Paid time off.