Manager, Value Based Care Program Operations
RemoteUnited States
United StatesRemoteFull TimeMedium
Full TimeMedium
Job Summary
Map technology needs and establish workflows for Medicare, Medicare Advantage, and Commercial value-based care programs. Monitor contract key indicators, coordinate quality performance data submission, and lead provider engagement to ensure performance outcomes. Design processes for population management, risk adjustment, and quality measures while collaborating with ACO partners on contract strategies. Manage provider roster attribution, communicate government regulations, and support internal teams in implementing best practices.
Required Qualifications
- Bachelor's degree
- 5+ years of experience working in health plans, health systems, or provider organizations, managing value-based and risk-based contracts
- Strong understanding of ambulatory clinical operations and VBC programs
- Analytical, quantitative, and metrics driven; must know how to interpret value-based program requirements and understand the impact on financial results
- Must comply with HIPAA rules and regulations
- Must have experience with MSSP ACO, ACO REACH, or Medicare Advantage programs
- Less than 20% travel required
Desired Qualifications
- RN or clinical background
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