Principal Value-Based Care Operations Advisor

🏢 Blue Cross NC · all Blue Cross NC jobs
📍 United States
💰 USD 130,560 - 208,896 / annual
📅 Posted 2026-08-22 · via Himalayas
🏷 Healthcare-Operations,Value-Based-Care,Healthcare-Strategy,Healthcare-Consulting,Provider-Operations,Value-Based-Care-Operations,Value-Based-Care-Leadership
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Job Description
Leads enterprise efforts supporting the design, operationalization, and optimization of value-based care programs across the full operational lifecycle. The Principal Value-Based Care Operations Advisor provides subject matter expertise spanning program design, contract execution, performance measurement, operational workflows, and financial reconciliation to ensure value-based care initiatives achieve intended clinical, financial, and operational outcomes.

This role partners across clinical, network, finance, actuarial, analytics, and operational teams to translate strategic value-based care objectives into scalable operating models. The position drives alignment across federated stakeholders and ensures programs are operationally executable, measurable, and sustainable. What You Will Do

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Lead end-to-end operational design of value-based care programs, including shared savings, downside risk, and alternative payment models.

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Translate strategic program objectives into operational workflows, governance structures, and execution plans.

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Identify operational gaps across contracting, attribution, performance measurement, reporting, and financial settlement processes.

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Partner with clinical, finance, actuarial, analytics, and network teams to ensure alignment between program design and operational execution.

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Support development and refinement of VBC operating models and cross-functional processes.

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Evaluate program performance drivers and recommend operational improvements to enhance outcomes and financial sustainability.

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Provide expertise supporting implementation of new reimbursement models and provider partnership strategies.

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Lead complex cross-functional initiatives requiring coordination across enterprise stakeholders and external partners.

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Support provider engagement strategies by ensuring operational readiness and clarity of performance expectations.

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Establish repeatable processes and controls supporting program scalability and measurement integrity.

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Identify risks to program execution and develop mitigation strategies across operational domains.

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Present operational insights, performance implications, and strategic recommendations to senior leadership.

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Serve as a subject matter expert for value-based care operations and enterprise transformation initiatives.

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Mentor and guide team members supporting value-based care program delivery.

What You Bring

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Bachelor’s degree or advanced degree in healthcare administration, business, public health, or related field.

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8+ years of experience in healthcare operations, value-based care programs, payer-provider strategy, or healthcare consulting.

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Demonstrated experience supporting or operating value-based care models including total cost of care or risk-based arrangements.

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Experience working across multiple healthcare domains including clinical operations, finance, analytics, and network/provider engagement.

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Strong understanding of healthcare reimbursement and performance measurement concepts.

In lieu of degree: 10+ years of directly related healthcare experience.
Preferred Qualifications

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Experience operationalizing Medicare Advantage and Commercial VBC programs.

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Experience supporting shared savings reconciliation or financial settlement processes.

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Familiarity with attribution methodologies, performance measurement frameworks, and population health analytics.

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Experience working within payer organizations or integrated delivery systems.

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Consulting or enterprise transformation experience supporting healthcare operating model design.

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This role provides operational leadership ensuring value-based care strategies translate into executable and sustainable programs. The position bridges strategy and execution by aligning program design, operational workflows, and performance measurement across enterprise stakeholders.

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The Principal Value-Based Care Operations Advisor focuses on o

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