Director, Value Based Programs
About this role
WHO WE ARE
NeueHealth is a value-driven healthcare company grounded in the belief that all health consumers are entitled to high-quality, coordinated care. By uniquely aligning the interests of health consumers, providers, and payors, we help to make healthcare accessible and affordable to all populations across the ACA Marketplace, Medicare, and Medicaid.
NeueHealth delivers clinical care to health consumers through our owned clinics – Centrum Health and Premier Medical – as well as unique partnerships with affiliated providers across the country. We also enable providers to succeed in performance-based arrangements through a suite of technology and services scaled centrally and deployed locally. Through our value-driven, consumer-centric approach, we are committed to transforming healthcare and creating a better care experience for all.
As a leader in value-based care, NeueHealth participates in the Centers for Medicare and Medicaid Services’ (CMS) and CMMI’s portfolio of alternative payment models. We are hiring a Director to support the value-based care program strategy and operations and evaluate new innovation model opportunities. In this highly visible role, the Director will report to the VP, Government Programs and Business Development and will manage a diverse portfolio that includes program evaluation and application writing, market analyses, policy updates, and stakeholder presentations. As an integral member of the team, the Director will work across teams to manage key deliverables, and collaborate directly with the VP, Government Programs and Business Development on strategic initiatives.
Preferred locations for candidates are Miami, FL and Minneapolis, MN.
ROLE RESPONSIBILITIES
- Under the direction of the VP of Business Development and Government programs, set NeueHealth’s strategy for value-based care initiatives, including Accountable Care Organizations (ACOs) and other CMS/CMMI alternative payment models.
- Serve as a subject matter expert on CMS alternative payment models, value-based care transformation, and population health management strategies, including benefit enhancements, beneficiary engagement incentives, and specialist integration
- Develop and deliver executive-level presentations, strategic recommendations, and stakeholder communications regarding program performance, market opportunities, and regulatory developments.
- Evaluate and pursue participation in new CMS and CMMI innovation models, including conducting strategic assessments, financial analyses, and operational readiness evaluations.
- Lead development of model applications, responses to Requests for Applications (RFAs), and other CMS/CMMI submissions, ensuring alignment with organizational strategy and compliance requirements.
- Oversee program implementation and ongoing management for Medicare Shared Savings Program (MSSP), LEAD, AHEAD, and other government-sponsored value-based care initiatives.
- Monitor and interpret federal healthcare policy, CMS rulemaking, and CMMI model updates and own relationships with trade associations (NAACOs, APG, etc.); translate regulatory changes into actionable business and operational strategies.
- Conduct market research and competitive analyses to identify growth opportunities, partnership strategies, and emerging trends in value-based care and government programs.
- Partner cross-functionally with clinical, actuarial, finance, operations, network management, analytics, compliance, legal, and practice transformation teams to drive successful program execution.
- Other duties as required
SUPERVISORY RESPONSIBILITIES
This role has supervisory responsibilities.
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
- A Bachelor’s degree with a concentration in economics, business, public health, community health, healthcare administration or related field is required. An MBA, MHA, or MPP is preferred.
- 7+ years professional experience in health care consulting, policy, value-based care program management, or internal strategy
- Prior experience with CMS models, such as MSSP or ACO REACH
- Experience managing teams in a remote environment.
- Genuine interest in value-based care
- Proficiency with MS Office tools including Excel, PowerPoint, and Word required
PROFESSIONAL COMPETENCIES
- Critical thinker with the ability to identify, solve problems, and thrive in a fast-paced environment.
- Ability to independently draft PowerPoint presentations with “story telling”
- Strong communication skills, both verbal and written
- Organized and able to prioritize work to meet deadlines
- Results and detail-oriented; accountable for their work
- Comfortable working with large data sets
- Team-player; contributes to a collaborate culture
WORK ENVIRONMENT
The majority of work responsibilities are performed in a hybrid office setting, carrying out detailed work sitting at a desk/table and working on the computer. Travel may be required.
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