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Vice President of Value-Based Care Contracting

US Heart and Vascular

US Heart and Vascular

Franklin, TN, USA
Posted 6+ months ago

Position Summary

US Heart and Vascular (USHV) is seeking a full-time Vice President of Value-Based Care Contracting (VP VBC Contracting) to lead our value-based contracting across the organization. The VP VBC Contracting will be responsible for overseeing the successful development and execution of advanced payment model contracts. This leader will serve as a strategic owner of the function and plays a critical role in the organization's strategic direction. You will be accountable for a pipeline of payer relationships including Commercial health plans, Medicare Advantage, Advanced Primary Care, and Self-Funded employer groups. Key activities include establishing and implementing goals and strategy, managing the pipeline, negotiating with payers, coordinating with the SVP of Payer Strategy to ensure alignment across our portfolio of contracts, and coordinating with our Healthcare Economics function to ensure contracts are financially sustainable. You should be equally comfortable leading strategic discussions with payer partners as you are rolling your sleeves up to support the team. This role will work collaboratively across teams to deliver business outcome

Responsibilities & Duties

· Develops, implements, and continually evaluates the strategic direction for VBC contracting

· Guides and participates in negotiations with payers to ensure favorable contract terms that align with USHV objectives

· Establishes and maintains strong relationships with payer partners , serving as the key point of contact for contract-related discussions and issue resolution.

· Leads contract evaluation and assesses financial viability, operational feasibility, and alignment overall USHV objectives in partnership with operational, financial, and clinical leaders across the organization

· Develops and implements metrics for active daily management of the work and reporting status to key stakeholders

· Supports the implementation of VBC contracts post signing to ensure a smooth transition to operations

· Collaborates with internal and external stakeholders to align contract terms and address contract-related issues.

· Provides expert knowledge of value-based care contracting to inform contract negotiations

· Monitors market trends, competitor practices, and emerging value-based care models, providing insights and recommendations to inform underwriting strategies

Knowledge, Skills and Abilities Required

· Bachelor’s degree

· Prefer Master’s degree in Business Administration, Healthcare Administration or related field

· 5+ years experience in value-based contracting within a provider organization, payer, or healthcare consulting firm

· Strong proficiency in data analysis and presentation development

· Strong track record in developing value-based contracts, from initiation through implementation

· In-depth knowledge of value-based care models, healthcare reimbursement methodologies, and regulatory requirements

· Experience working with actuarial teams and familiarity with risk adjustment methodologies (e.g., HCC coding).

· Excellent communication, collaboration, presentation, and negotiation skills

· Proven track record of driving results, influencing decision-making, and fostering collaboration in a matrixed organizational structure.