Director, Value-Based Care and Network Strategist

3 weeks ago


Worcester, Massachusetts, United States Central Mass Health LLC Full time
Job Description

Central Mass Health LLC is seeking a highly skilled Director, Value-Based Care and Network to lead and execute the company's value-based care and network strategy. This individual will be responsible for developing and implementing a comprehensive value-based care and network plan that aligns with the company's goals and objectives.

Key Responsibilities

  • Develop and implement a value-based care and network strategy that aligns with the company's goals and objectives.
  • Lead and manage a team of healthcare professionals to develop and implement value-based care and network initiatives.
  • Collaborate with internal stakeholders to ensure alignment and integration of value-based care and network initiatives with other company initiatives.
  • Develop and maintain relationships with external stakeholders, including healthcare providers, payers, and vendors.
  • Monitor and evaluate the effectiveness of value-based care and network initiatives and make recommendations for improvement.

Requirements

  • Bachelor's degree in business, healthcare administration, or related field.
  • 8+ years of experience in value-based care and network management, preferably in Medicare Advantage and/or managed care.
  • Minimum 5 years of experience in healthcare, including knowledge of health plan operations, such as claim processing, customer service, and enrollment.
  • Minimum 3 years of experience in risk adjustment and quality and impact to provider workflows.

Preferred Qualifications

  • Proven track record of working collaboratively with clinical and operational colleagues across the organization.
  • Ability to communicate effectively and lead by influence to engage colleagues and lead teams cross-functionally.
  • Experience in fostering networks with internal and external stakeholders.
  • Possess strong business acumen, excellent strategic thinking, and effective problem-solving skills.


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