Full-Time Sr. Manager, Value-Based Care Ops

Sr. Manager, Value-Based Care Operations will manage a diversified value-based care platform with 100+ VBC contracts and over 1 million attributed lives in commercial, Medicare (Medicare Advantage & MSSP), and Medicaid lines of business across 14 states.

Responsibilities include:

1. Implementation and management of existing and new value-based care arrangements and operations.
2. Managing risks and developing opportunities with value-based care teams.
3. Creating, refining, and leading implementation workflows for quality, cost, and risk adjustment.
4. Identifying and building relationships with business owners to solve operational gaps with payer partners.
5. Demonstrating analytical/quantitative thinking around economic and clinical drivers of success in VBC programs.
6. Developing action plans with internal and external stakeholders to improve performance.
7. Providing value-based program operationalization training to internal and external stakeholders.
8. Partnering with cross-functional teams to drive operational decisions and oversee project progress.
9. Developing and maintaining strategic relationships with payers at a national level.
10. Serving as the escalation point for issues.
11. Developing and managing projects, including scope, requirements, plans, risk mitigation, communication, and issue resolution.
12. Developing project deliverables with minimal supervision, such as project plans, presentations, status reports, meeting minutes, and issue logs.
13. Presenting findings and recommendations to stakeholders.
14. Monitoring project implementation and progress.
15. Managing workgroups, committee meetings, and best practice sharing events.

Qualifications:

• Bachelor's degree or equivalent experience
• 5+ years of experience
• 2+ years in managed care operations, value-based care, provider reimbursement, or analytics
• Understanding of commercial, Medicare Advantage, and Medicaid managed care
• Project management experience
• Strong interpersonal skills, collaborative approach, and ability to manage conflicts
• Strong organizational, problem-solving, communication, and client-facing skills
• Compliance with HIPAA rules and regulations

Technical Requirements (Remote Workers Only):

• 5 MBPS Download Speed
• 3 MBPS Upload Speed

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