Lead, Value-Based Care Programs (Remote)

Astrana Health, Inc.; Palm Coast (FL); Remote; USD 85,000 - 105,000; Full time

Job summary

Astrana Health, Inc. is seeking a Lead, Value-Based Care Programs to guide MSSP quality reporting and program initiatives remotely in the United States. You will drive data-driven quality improvements, coordinate with ACO leadership, and ensure compliance with CMS reporting requirements.

The role requires 5+ years in healthcare operations or quality improvement, strong EHR and analytics skills, and effective cross-functional collaboration to improve care outcomes and physician engagement.

Qualifications

• 5+ years’ experience in healthcare or managed care in medical operations and/or quality improvement
• Bachelor’s degree or higher in a relevant field is required
• Experience with MSSP quality reporting preferred
• Strong knowledge of CMS quality reporting requirements and regulatory standards
• Proficiency in data analytics and data visualization tools

Responsibilities

• Partners with ACO and Value-Based Care Programs leadership to align program strategy with organisational goals and performance objectives
• Serves as primary owner for MSSP Quality Reporting, overseeing processes, deliverables, and compliance with program requirements
• Drives quarterly and annual quality reporting, ensuring accuracy, timeliness, and adherence to MSSP and other value-based care standards
• Uses data analytics and reporting to increase visibility into performance, identify trends, and proactively monitor quality outcomes
• Independently investigates and resolves complex quality performance and reporting issues, identifying root causes and implementing corrective actions
• Acts as escalation point for quality performance, reporting, and data-related concerns from participating physician practices and internal stakeholders
• Evaluates reporting workflows and operational processes; recommends improvements to enhance efficiency, data integrity, compliance, and overall program effectiveness
• Provides and coordinates training for Provider Relations and Market Managers to support providers in meeting ACO quality performance and reporting requirements
• Serves as subject matter expert on MSSP quality reporting, quality measure performance, and value-based care program requirements
• Engages in clinical and quality programmes to ensure regulatory changes, program developments, and reporting requirements are communicated to leadership and participating physicians
• Develops and supports internal and external clinical and quality initiatives through all project phases to improve care coordination, communication, and patient outcomes
• Builds and maintains effective working relationships with physician practices, healthcare partners, and cross-functional teams
• Participates in and contributes to quality, clinical, and related governance committees, as needed
• Escalates significant issues and risks to leadership with clear analyses and recommended solutions
• Communicates complex business, operational, and technical issues, recommendations, and solutions to diverse audiences
• Leads reporting-related projects, initiatives, and process improvements through expertise, influence, and cross-functional collaboration
• Performs other duties as assigned

Skills

Project management

Quality reporting

Healthcare knowledge

EHR systems

Microsoft Office

Education

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

Master’s degree in healthcare administration or public health preferred

Tools

EHR platforms

SharePoint/OneDrive

Job description

Astrana Health, Inc. is seeking a Lead, Value-Based Care Programs to guide MSSP quality reporting and program initiatives remotely in the United States. You will drive data-driven quality improvements, coordinate with ACO leadership, and ensure compliance with CMS reporting requirements.

The role requires 5+ years in healthcare operations or quality improvement, strong EHR and analytics skills, and effective cross-functional collaboration to improve care outcomes and physician engagement.