VBC Program Manager

Vitae Health Systems

United States

Remote

USD 105,000 - 120,000

Full time

8 days ago

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Benefits offered by this job

Work From Home

Health Care Plan

401k

Paid Time Off

Job summary

Vitae Health Systems is seeking a hands‑on VBC Program Manager to build and run the LEAD ACO operating rhythm, ensure alignment with CMS requirements, and translate performance data into actionable improvements.

You will lead the VBC operations team, coordinate with clinical and data partners, manage weekly/ monthly cadences, and ensure on‑time delivery of milestones, with clinical standards maintained by leadership.

Qualifications

Bachelor’s degree in healthcare administration, public health, business, nursing, or related field.
4+ years in value-based care or population health; provider-side preferred.
Experience with CMS ACO models (ACO REACH/LEAD).
Experience in post-acute, SNF, or long-term care.
2+ years managing staff.
Strong data and performance cadence skills.
Ability to drive cross-functional follow-through.

Responsibilities

Lead LEAD ACO operating cadence and performance tracking.
Manage weekly huddle and monthly performance reviews.
Monitor utilization drivers and assign owners for high‑risk patients.
Review CMS reports and flag variances; escalate risks.
Maintain CMS deadline calendar with owners.
Oversee CMS alignment reconciliation and pre‑submission reviews.
Lead root cause analyses and drive improvement cycles.
Coordinate with VBC clinical and operations teams.
Develop provider‑facing materials with data owners.
Support quarterly improvement cycles with cross‑functional partners.
Coach and develop VBC operations team.
Provide staffing input as scope grows.

Skills

CMS ACO knowledge

VBC operations

Staff management

KPI tracking

BI dashboards

EHR data

Cross-functional leadership

Excel

Education

Bachelor’s degree

Tools

Excel

BI dashboards

EHR data

Job description

Compensation: $105,000 - $120,000

Reports to: Director of VBC Operations

Direct Reports: VBC Operations Coordinators and Patient Engagement Representative

Location: Remote (with the ability for limited travel to facility partners and team meetings)

About Vitae Health Systems:

Founded in 2018, Vitae Health Systems is one of the largest providers of behavioral health, internal medicine, and podiatry services to residents of Skilled Nursing and Assisted Living Facilities. Headquartered in Chicago, IL, we currently operate in over 10 states and are rapidly expanding throughout the USA.

Overview

Vitae launches its ACO under the CMS Long-term Enhanced ACO Design (LEAD) Model on January 1, 2027, building on our experience in ACO REACH High Needs. The VBC Program Manager builds and runs the operating rhythm of the LEAD ACO, making sure the work that drives results (beneficiary alignment, utilization, quality performance, and program compliance) is tracked, scheduled, and followed through on time.

This is a hands‑on operating role. You will lead the VBC operations team, run the weekly and monthly performance cadence with the VBC data resource, and work with the VBC clinical team and operations managers to turn performance data into clear, prioritized actions. You own the calendar, the cadence, and the follow‑through. Clinical standards and compliance decisions remain with clinical and compliance leadership.

Key Responsibilities

LEAD ACO Operating Cadence and Performance Tracking

Run the weekly team huddle and monthly performance review covering alignment, utilization, quality, and reported spend, using KPIs and targets set by VBC leadership.
Track performance against the LEAD quality measures and Prevention and Quality Plan milestones, and report variances to leadership.
Monitor utilization drivers (admissions, readmissions, ED visits, post‑acute stays) and confirm high‑risk patients have a named owner and documented action, escalating gaps to clinical leadership.
Review operational CMS reports and data feeds monthly, flag variances early, and elevate risks with a recommended path.
Maintain the master calendar of CMS deadlines and deliverables, with a named owner for each, and follow up so nothing is missed.

Alignment and Compliance Oversight

Oversee the voluntary alignment program against leadership‑set targets and deadlines, including a documented pre‑submission review before each CMS submission.
Oversee reconciliation of CMS alignment lists to census and EHR data, and lead root cause reviews on avoidable attrition (deaths, hospice elections, moves, Medicare Advantage enrollment).
Reconcile Participant and Preferred Provider lists to HR and credentialing records at the TIN/NPI level, escalating any change that needs a leadership or Compliance decision.
Verify that beneficiary notifications and outreach activities are completed, tracked, and documented to CMS requirements, in partnership with Compliance.

Cross‑Functional Partnership

Work with operations managers on how VBC activities are scheduled and delivered at the facility and NP level, surfacing barriers early and avoiding unnecessary burden.
Partner with VBC clinical leadership so workflows, checklists, and handoffs reflect clinical standards.
Support development of provider‑facing materials (scorecards, tip sheets, trainings) with the clinical and data owners, coordinating timelines and operational input.

Data, Reporting & Continuous Improvement

Submit and sequence reporting requests to the VBC data resource through a single intake, review data for reasonableness before use in reviews, and flag manual work that could be automated.
Prepare the performance summaries the Director of VBC Operations presents to senior leadership and ACO governance, aggregating data, clinical, and operational input.
Lead root cause reviews when measures move off target and turn findings into action plans with named owners and due dates, tracking each to closure and routing clinical actions to clinical leadership.
Facilitate a quarterly improvement cycle (plan, do, study, act) based on financial and performance results, with the Director of VBC Operations as sponsor: convene Finance, clinical, and data partners to select opportunities, assign actions, evaluate results, and document learning in a VBC operating playbook.

Team Leadership

Lead the VBC operations team and serve as its first point of contact: coach, set priorities and escalation thresholds, build SOPs with process owners, and resolve operational questions and blockers within defined boundaries, escalating strategic, financial, compliance, and policy matters to the Director of VBC Operations.
Provide input to the Director of VBC Operations on structure and staffing as scope grows.

What Success Looks Like

First 90 days: The master CMS calendar is in place with named owners. The weekly and monthly cadence is running and escalation thresholds are defined. The first quarterly improvement cycle is launched, with opportunities, owners, measures, and evaluation dates set. Team members have clear goals and documented workflows.
First year: Two or more improvement cycles are completed with documented results and feed a VBC operating playbook. Alignment, quality, and utilization are tracked against targets all year, with action plans when a measure is off target. Escalations arrive with context and a recommended path.

Required

Bachelor’s degree in healthcare administration, public health, business, nursing, or a related field
4+ years in value-based care, ACO operations, or population health (provider-side strongly preferred)
Direct experience in a CMS ACO model (ACO REACH, especially High Needs, MSSP, or LEAD)
Experience in post-acute, SNF, or long-term care
2+ years managing staff
Track record running recurring operating cadences and hitting deadlines
Experience running structured improvement cycles (e.g., PDSA, Lean) and building playbooks
Working knowledge of CMS alignment (claims-based and voluntary), ACO quality measures, beneficiary protections and marketing requirements, and benchmark and settlement basics
Ability to drive follow-through across clinical, operational, and data teams without direct authority
Clear communicator who can explain data to clinicians and leaders, and is comfortable with financial and utilization reports, Excel, BI dashboards, and EHR data

Preferred