Senior Value-Based Care Operations Leader

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

Benefits offered by this job

Annual incentive bonus

401(k) with employer match

Paid Time Off (PTO)

Health benefits

Wellness programs

Job summary

Blue Cross NC seeks a Principal Value-Based Care Operations Advisor to lead end-to-end operational design of value-based care programs, including shared savings, risk-based models, and alternative payment structures. You will translate strategy into scalable workflows, collaborate with clinical, finance, analytics, and network teams, and drive measurable outcomes across enterprise programs.

This role focuses on operational execution and program performance, guiding cross-functional teams to

Qualifications

• Bachelor's or advanced degree required in healthcare-related field.
• 8+ years in healthcare operations or value-based care.
• Experience with value-based care models including total cost of care or risk-based arrangements.
• Ability to work across clinical operations, finance, analytics and network engagement.

Responsibilities

• Lead end-to-end design of value-based care programs and models.
• Translate objectives into operational workflows, governance and execution plans.
• Identify gaps across contracting, attribution, performance measurement and settlements.
• Partner with clinical, finance, analytics and network teams for alignment.
• Support development and refinement of VBC operating models and processes.
• Evaluate drivers and recommend improvements for outcomes and sustainability.
• Provide expert support for implementation of new reimbursement models.
• Lead cross-functional initiatives across enterprise stakeholders and partners.
• Support provider engagement with clear performance expectations.
• Establish repeatable processes and controls for scalability and measurement.
• Identify risks and develop mitigation across operational domains.
• Present insights and recommendations to senior leadership.
• Serve as SME for value-based care operations and enterprise transformation.
• Mentor and guide team members delivering VBC programs.

Skills

Healthcare Operations

Healthcare Process Improvement

Healthcare Reimbursement

Operational Efficiency

Operational Process Improvements

People Management

Project Management

Provider Reimbursement

Reporting and Analysis

Strategic Planning

Education

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

Job description

Blue Cross NC seeks a Principal Value-Based Care Operations Advisor to lead end-to-end operational design of value-based care programs, including shared savings, risk-based models, and alternative payment structures. You will translate strategy into scalable workflows, collaborate with clinical, finance, analytics, and network teams, and drive measurable outcomes across enterprise programs.

This role focuses on operational execution and program performance, guiding cross-functional teams to