Principal Value-Based Care Operations Advisor

🔥 0 minutes ago

🐎 Kentucky, Louisiana, +3 more states – Remote

🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🌲 North Carolina – Remote 🎸 Mississippi – Remote 🌴 South Carolina – Remote

💵 $130.6k - $208.9k / year

⏰ Full Time

🔴 Lead

⚙️ Operations

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Blue Cross NC

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

Founded 1933

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Blue Cross NC is a health insurance provider that offers a range of health plans and services to individuals and groups. The company focuses on delivering quality healthcare coverage and improving health outcomes for its members through innovative health programs and services. Blue Cross NC is committed to enhancing access to affordable healthcare while supporting the health and wellness of the communities it serves.

📋 Description

• 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

🎯 Requirements

• 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

🏖️ Benefits

• 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