Director, Value-Based Care Payer Operations

DuPage Medical Group LTD; Highland Oaks (GA); On-site; USD 125,000 - 188,000; Full time

Benefits offered by this job

Medical, dental, and vision benefits

Tuition reimbursement

Immediate 401(k) match

Volunteer time off (VTO)

Job summary

Duly Health and Care is seeking a Director of VBC Payer Operations & Implementation to orchestrate scalable, high-performing payer initiatives within a physician-led system. You will translate complex contracts into concrete programs, align clinical, operational, analytic, and payer stakeholders, and drive execution with a disciplined cadence.

This full-time role in Downers Grove, IL requires 7+ years in healthcare operations and experience with Medicare Advantage, ACO REACH, and MSSP.

Qualifications

• 7+ years of progressive experience in healthcare operations, payer contracting, value-based care, or related programs.
• Working knowledge of Medicare Advantage, ACO REACH, and MSSP programs.
• Demonstrated experience supporting the execution of risk-based or value-based contracts.
• Proven ability to lead cross-functional initiatives and collaborate with teams such as utilization management and care management.

Responsibilities

• Implement and Run Partial Risk Plans
• Own implementation and ongoing execution of partial risk contracts
• Translate contract requirements into specific, operational initiatives
• Partner with operations to build and deploy BPAs and workflow changes embedded in physician practice
• Lead a weekly execution workgroup to drive timelines, adoption, and issue resolution
• Manage Performance
• Partner with Analytics/IT to build and use dashboards that track initiative execution and results
• Monitor performance and actively course-correct when targets are missed
• Work directly with payers to validate and improve reporting
• Present implementation status and results to the President and steering committee
• Own and maintain action tracker and facilitate payer JOCs as needed
• Drive Improvement & Additional Initiatives
• Identify and implement performance improvement opportunities
• Support ad hoc payer, strategic, and enterprise initiatives as they arise, including analysis, partnership evaluation, and special projects

Skills

Healthcare operations

Payer contracting

Value-based care

Cross-functional leadership

Analytics

Education

Bachelor's degree

Job description

Duly Health and Care is seeking a Director of VBC Payer Operations & Implementation to orchestrate scalable, high-performing payer initiatives within a physician-led system. You will translate complex contracts into concrete programs, align clinical, operational, analytic, and payer stakeholders, and drive execution with a disciplined cadence.

This full-time role in Downers Grove, IL requires 7+ years in healthcare operations and experience with Medicare Advantage, ACO REACH, and MSSP.