Principal Value-Based Care Operations Advisor

🕒 vor 4 Tagen

🐎 Kentucky, Louisiana, +3 weitere Bundesländer – Remote

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💵 $130.560 - $208.896 / Jahr

⏰ Vollzeit

🔴 Experte

⚙️ Operations

👻 Geisterscore 0%

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🗣️🇺🇸🇬🇧 Englisch erforderlich

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Logo of Blue Cross NC

Blue Cross NC

5001 - 10000 Mitarbeiter

Gegründet 1933

🏥 Gesundheitswesen

🛡️ Versicherung

⚕️ Krankenversicherung

Healthcare • Insurance • Healthcare Insurance

Blue Cross NC ist ein Krankenversicherungsanbieter, der eine Vielzahl von Gesundheitsplänen und -diensten für Einzelpersonen und Gruppen anbietet. Das Unternehmen konzentriert sich darauf, Qualitäts-Gesundheitsversorgung bereitzustellen und die Gesundheitsergebnisse für seine Mitglieder durch innovative Gesundheitsprogramme und -dienste zu verbessern. Blue Cross NC hat sich verpflichtet, den Zugang zu erschwinglicher Gesundheitsversorgung zu verbessern und gleichzeitig die Gesundheit und das Wohlbefinden der Gemeinschaften, denen es dient, zu unterstützen.

Beschreibung

• Lead end-to-end operational design of value-based care programs, including shared savings, downside risk, and alternative payment models • Translate strategic program objectives into operational workflows, governance structures, and execution plans • Identify operational gaps across contracting, attribution, performance measurement, reporting, and financial settlement processes • Partner with clinical, finance, actuarial, analytics, and network teams to align program design and operational execution • Support development and refinement of value-based care operating models and cross-functional processes • Evaluate program performance drivers and recommend improvements to enhance outcomes and financial sustainability • Support implementation of new reimbursement models and provider partnership strategies • Lead complex cross-functional initiatives with enterprise stakeholders and external partners • Support provider engagement strategies by ensuring operational readiness and clear performance expectations • Establish repeatable processes and controls for program scalability and measurement integrity • Identify execution risks and develop mitigation strategies • Present operational insights, performance implications, and strategic recommendations to senior leadership • Serve as a subject matter expert for value-based care operations and enterprise transformation initiatives • Mentor and guide team members supporting value-based care program delivery

🎯 Anforderungen

• Bachelor’s degree or advanced degree in healthcare administration, business, public health, or related field, or 10+ years of directly related healthcare experience in lieu of degree • 8+ years of experience in healthcare operations, value-based care programs, payer-provider strategy, or healthcare consulting • Demonstrated experience supporting or operating value-based care models including total cost of care or risk-based arrangements • Experience across clinical operations, finance, analytics, and network/provider engagement • Strong understanding of healthcare reimbursement and performance measurement concepts • Experience operationalizing Medicare Advantage and Commercial VBC programs preferred • Experience supporting shared savings reconciliation or financial settlement processes preferred • Familiarity with attribution methodologies, performance measurement frameworks, and population health analytics preferred • Experience working within payer organizations or integrated delivery systems preferred • Consulting or enterprise transformation experience supporting healthcare operating model design preferred • Authorization to work in the United States

🏖️ Vorteile

• Annual Incentive Bonus based on annual corporate goal achievement and individual performance • 401(k) with employer match • Paid Time Off (PTO) • Competitive health benefits • Wellness programs • Reasonable accommodations for applicants with disabilities

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