Senior Value-Based Care Operations Architect

Blue Cross and Blue Shield of North Carolina; Arizona; On-site; USD 131,000 - 209,000; Full time

Job summary

Blue Cross NC seeks a Principal Value-Based Care Operations Advisor to lead enterprise efforts in designing and operationalizing value-based care programs across the full lifecycle.

The role partners with clinical, finance, actuarial, analytics, and network teams to translate objectives into executable operating models, ensuring measurable, sustainable results and strong leadership across federated stakeholders.

Qualifications

• Bachelor's degree or advanced degree in healthcare administration, business, public health, or related field.
• 8+ years of experience in healthcare operations, value-based care programs, payer-provider strategy, or healthcare consulting.
• Demonstrated experience supporting or operating value-based care models including total cost of care or risk-based arrangements.
• Experience across clinical operations, finance, analytics, and network engagement.

Responsibilities

• Lead end-to-end operational design of value-based care programs, including shared savings, downside risk, and alternative payment models.
• Translate strategic program objectives into operational workflows, governance structures, and execution plans.
• Identify operational gaps across contracting, attribution, performance measurement, reporting, and financial settlement processes.
• Partner with clinical, finance, actuarial, analytics, and network teams to ensure alignment between program design and operational execution.
• Support development and refinement of VBC operating models and cross-functional processes.
• Evaluate program performance drivers and recommend operational improvements to enhance outcomes and financial sustainability.
• Provide expertise supporting implementation of new reimbursement models and provider partnership strategies.
• Lead complex cross-functional initiatives requiring coordination across enterprise stakeholders and external partners.

Skills

Healthcare Operations

Value-based care

Payer-provider strategy

Team leadership

Performance measurement

Education

Bachelor's or advanced degree

Job description

Blue Cross NC seeks a Principal Value-Based Care Operations Advisor to lead enterprise efforts in designing and operationalizing value-based care programs across the full lifecycle.

The role partners with clinical, finance, actuarial, analytics, and network teams to translate objectives into executable operating models, ensuring measurable, sustainable results and strong leadership across federated stakeholders.