Director, Value Based Care Network & Operations Strategy
Core
Develop and implement network and operational strategies to improve Total Cost of Care (TCoC) for older adults in a Medicare Advantage context.
Role type
Director, Value-Based Care Network & Operations Strategy
Builds
Non-clinical affordability initiatives, optimized provider networks, and operational performance improvements.
Domain
Healthcare (Medicare Advantage, Value-Based Care, Senior Care)
Required skills
Value-based care strategy, provider network design, claims operations, payment methodologies, healthcare economics, cross-functional leadership, financial data analysis, stakeholder management.
Preferred skills
Medicare Advantage experience, knowledge of high-cost care initiatives (CAR-T, transplant), AI application in operations.
Technologies
None explicitly stated.
Responsibilities
Partner with Clinical Programs to execute TCoC improvement opportunities; lead non-clinical cost management programs; lead network design and specialty contracting; resolve operational issues impacting medical costs; develop executive reporting on TCoC performance; supervise and manage team members.
Seniority
Director, 5+ years leadership experience.