Director of Value Based Care

The Director of Value-Based Care is a highly influential role dedicated to driving care transformation and contributing significantly to the organization’s growth and change in the coming years. This position combines strategic vision with operational excellence, ensuring seamless integration between the health plan and value based clinical assets and innovative strategies to enhance healthcare outcomes and manage costs.

Responsibilities include developing and leading the Value-Based Care Model, overseeing daily operations, managing existing and expanding value-based programs, and driving performance in clinical and cost indicators. The role also involves fostering clinical innovation, ensuring financial stewardship, and championing a culture of service excellence. Additionally, the Director will engage with stakeholders and facilitate a Clinical Advisory Workgroup to evaluate best practices. A strong understanding of value-based care, healthcare trends, and data management is essential

• Leadership and Strategy: Develop and lead the Value-Based Care Model by codifying and implementing clinical best practices. Drive strategic initiatives that enhance value-based care and promote a culture of continuous improvement and innovation.

• Operational Management: Oversee daily clinical and business operations of assigned departments, ensuring efficient and high-quality practices. Provide direct supervision of front-line staff and administrative oversight of employed clinicians.

• Program Management: Manage value-based programs including Comprehensive Health Assessments, Outreach, Wellness, Primary Care at Home, Chronic Care Management, and Transitional Care Management.

• Value Based Care Performance: This leader will be a champion for value-based care, drive key clinical and cost performance indicators, and establish the programs necessary to align clinical practice to measures of success. They will be responsible for the monitoring of utilization, pharmacy adherence, timely care, and other clinical quality outcomes.

• Financial Stewardship: Develop budget plans in alignment with organizational goals and ensure responsible financial management. Review dashboards and reports related to clinician performance, population health, quality, safety, and cost. The incumbent will work to obtain cost of care data on both the medical and pharmacy sides of the business to drive cost containment initiatives.

• Collaborative Innovation: Foster clinical innovation by leading the design and execution of programs to meet quality metrics and optimize clinical pathways. Collaborate with clinical leaders, network partners, and data management teams to integrate analytics into clinical workflows and drive performance improvement in quality, equity, and affordability.

• Service Excellence: Champion a culture of service excellence by implementing and monitoring standards of care that prioritize patient satisfaction and engagement. Regularly review patient feedback to identify areas for improvement and ensure that service delivery exceeds expectations.

• Stakeholder Engagement: Establish and maintain collaborative working relationships with business and industry partners. Convene and facilitate a Clinical Advisory Workgroup to evaluate and agree on evidence-based best practices.

This position does not provide patient care.

The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills and efforts or work conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.

Name

Description

Education:

Must have working-level knowledge of the English language, including reading, writing, and speaking English. Bachelor's degree or higher in Healthcare, Business Administration, Public Administration, or a related field. MBA, MHA, or MPH preferred

Experience:

• Minimum five (5) years of leadership experience within a healthcare organization.

• Minimum five (5) years of experience with healthcare technology and data management.

• Strong understanding of value-based care and healthcare industry trends.

• Deep understanding of Electronic Medical Record system optimization and use as a key work driver within value-based care.

• Demonstrated ability to lead multidisciplinary teams towards execution of strategy.

• Excellent interpersonal, written communication, and project management skills

License(s):

None

Certification(s):

None

Computer / Typing:

Must be proficient in Microsoft Office Suite, including Outlook, PowerPoint, Excel, Teams, and Word and have the ability to use the computer for online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.