Director of Value-Based Programs

Leading a team focused on value-based programs, the full-time remote Director of Value-Based Programs will develop and implement strategies to enhance risk adjustment revenue and achieve financial objectives across various lines of business. Key responsibilities Design and implement strategies to improve existing value-based initiatives and identify new opportunities for innovation Serve as the primary owner of value-based programs, managing contracts and collaborating with health plan leadership to achieve program goals Hire, train, and evaluate team performance while fostering a high-performance culture dedicated to best-in-class solutions Required qualifications At least 8 years of managed care experience, including value-based programs, or equivalent education and experience Minimum of 3 years in management/leadership roles with experience in Medicaid, Medicare, or Marketplace program design and implementation Knowledge of value-based programs, risk adjustment models, and quality metrics such as HEDIS and Medicare STARS Strong understanding of medical economics and financial reporting, with the ability to guide stakeholders through complex reconciliations Proven ability to innovate and manage complex processes within a highly matrixed organization