Director of Value-Based Programs

Job Summary

Leading a team focused on value-based programs, the full-time salaried Director of Value-Based Programs will develop and implement strategies to enhance financial performance and compliance in a remote setting.

Key responsibilities

• Design and implement strategies to improve existing value-based initiatives and identify new opportunities for risk adjustment revenue
• Manage value-based program contracts and collaborate with health plan leadership to set annual targets and develop provider relationships
• Oversee team performance, providing coaching and development to ensure high-quality execution of value-based strategies

Required qualifications

• At least 8 years of managed care experience, including expertise in value-based programs
• A minimum of 3 years in management or leadership roles
• Experience with Medicaid, Medicare, and/or Marketplace program design and implementation
• Knowledge of risk adjustment models and quality metrics such as HEDIS and Medicare STARS
• Proven ability to innovate and manage complex processes across multiple functional areas in a matrixed organization