Senior Director, Value-Based Contracting & Strategy

Alignment Healthcare USA, LLC in; Orange (CA); On-site; USD 150,000 - 225,000; Full time

Job summary

Alignment Health is recruiting for a senior role to lead value-based contracting, design of alternative payment models, and negotiation with IPAs, large physician groups, and health systems. You will manage the full cycle from planning to loading, coordinating with MSO Contracting and Market Leaders.

You will guide analytics of medical claims data, oversee contract performance, and align strategies with cost and quality goals. A deep background in Medicare Advantage value-based care is expected.

Qualifications

• Minimum 10 years of value-based contract negotiation in managed care or healthcare services.
• Experience negotiating with IPAs, large provider groups, and health systems.
• Strong skills in financial modeling and provider contract design.

Responsibilities

• Lead value-based contracting strategy and execution with cross-functional partners.
• Negotiate complex contracts including IPAs, health systems, and large groups.
• Oversee contract performance and value-based planning with MSO targets.
• Analyze medical claims data and model risk-based scenarios for contracts.
• Build and develop the contracting team with coaching and guidance.
• Coordinate cross-functional support across HEDIS, Credentialing, and Member Services.
• Drive complex cross-functional projects from assessment to implementation.

Skills

Value-Based Contract Negotiation

Financial Data Analysis

Alternative Payment Models

CMS Stars Knowledge

Cross-Functional Leadership

Project & Program Leadership

Education

Bachelor's degree in Healthcare Administration, Business, Finance, or related field

MBA or graduate degree (preferred)

Job description

Alignment Health is recruiting for a senior role to lead value-based contracting, design of alternative payment models, and negotiation with IPAs, large physician groups, and health systems. You will manage the full cycle from planning to loading, coordinating with MSO Contracting and Market Leaders.

You will guide analytics of medical claims data, oversee contract performance, and align strategies with cost and quality goals. A deep background in Medicare Advantage value-based care is expected.