Director Of Value-Based Programs
The Director of Value-Based Programs, at the direction of the Associate Vice President (AVP), Provider Relations, and line of business liaisons, provides strategic leadership for the health plan's value-based care (VBC) initiatives. This role provides leadership and direction for the end-to-end design, implementation, and management of alternative payment models (APMs) with provider partners to improve quality, manage cost, and enhance the member experience. The Director collaborates cross-functionally to ensure VBC programs align with enterprise goals and regulatory requirements across all lines of business. Works closely with value-based analytics, affordability, clinical, pharmacy, and medical economics teams.
Are you ready to make a difference? Choose to work for one of the most trusted companies in Kansas.
Why Join Us?
- Make a Positive Impact : Your work will directly contribute to the health and well-being of Kansans.
- Lead and Inspire : Guide and mentor your team to achieve their full potential and success.
- Family Comes First : Total rewards package that promotes the idea of family first for all employees.
- Dynamic Work Environment : Collaborate with a team of passionate and driven individuals.
What you'll do
Shape and guide the value-based care strategy across Medicare, Medicaid, and Commercial markets in alignment with enterprise objectives.Provide direction for the design and implementation of alternative payment models (shared savings, downside risk, bundled payments, global capitation, pay-for-performance, etc.).Identify and champion new VBC opportunities and partnerships that drive cost-effectiveness and quality improvement.Serve as a senior liaison with provider organizations, health systems, Accountable Care Organization (ACO)s, and Independent Practice Association (IPA)s to implement, manage, and advance value-based arrangements.Support development and negotiation of value-based contracts, including quality metrics, financial methodologies, and risk arrangements.Build and cultivate strong provider relationships to drive alignment, trust, and engagement in care transformation efforts.Guide the operational performance of VBC programs including implementation, data exchange, provider reporting, and issue resolution.Partner closely with internal teams (analytics, contracting, IT, care management, compliance) to operationalize programs and ensure smooth execution.Lead internal governance processes to monitor performance, identify barriers, and deploy corrective action plans.Leverage data-driven insights to measure provider performance, evaluate program effectiveness, and identify improvement opportunities.Collaborate with analytics teams to inform the design of provider dashboards and reports monitoring quality, utilization, risk adjustment, and financial performance.Synthesize and communicate VBC model results, including return on investment (ROI), shared savings / losses, and program KPIs, to internal leadership and external stakeholders.Lead and develop a high-performing VBC team (program managers, analysts, provider liaisons).Serve as an internal subject matter expert on VBC trends, models, and strategic alignment.Represent the health plan in external forums, provider meetings, and industry collaboratives.Knowledge / Skills / Abilities :
Deep understanding of value-based care, Alternative Payment Models (APMs), health care, and healthcare economics.Strong knowledge of provider contracting, quality measurement frameworks (HEDIS, Stars, etc.), and care delivery reform.Proven leadership, project management, and strategic thinking capabilities.Proven ability to influence and collaborate effectively with internal teams and external stakeholders.Experience with healthcare analytics tools and the ability to interpret model performance data.What you need :
Bachelor's degree in healthcare administration, public health, business, or a related field, required.Leadership experience, including managing teams and driving strategic initiatives required.8 years of progressive healthcare experience, including at least 3years leading value-based care, population health, or provider engagement programs required. Prior health plan experience preferred.Experience managing VBC programs for government-sponsored plans (Medicare Advantage, Medicaid MCOs) required.Familiarity with Centers for Medicare & Medicaid Services (CMS) Innovation Center models such as ACO REACH, PCF, MSSP, required.Clinical or public health background (e.g., RN, MPH, PharmD) preferred.Certifications such as PMP, CPHQ, or Lean Six Sigma preferred.Benefits & Perks :
Base compensation is only one component of your competitive Total Rewards packageIncentive pay program (EPIP)
Health / Vision / Dental insurance6 weeks paid parental leave for new mothers and fathersFertility / Adoption assistance2 weeks paid caregiver leave5% 401(k) plan matchingTuition reimbursementHealth & fitness benefits, discounts and resourcesOur Commitment to Connection and Belonging : At Blue Cross and Blue Shield of Kansas, we are committed to fostering a culture of connection and belonging, where mutual respect is at the foundation of our workplace. We provide equal employment opportunities to all individuals, regardless of race, color, religion, belief, sex, pregnancy (including childbirth, lactation, and related medical conditions), national origin, age, physical or mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information (including characteristics and testing), military or veteran status, family or parental status, or any other characteristic protected by applicable law.
Blue Cross and Blue Shield of Kansas conducts pre-employment drug screening, criminal conviction check, employment verifications and education as part of a conditional offer of employment.
