What are the responsibilities and job description for the VP of Operations position at Coastal Health Alliance?
Description
Vice President of Primary Care Operations
The Vice President of Primary Care Operations is a senior executive responsible for leading the transformation and performance of primary care services within a value-based care model. This role drives clinical, operational, and financial outcomes by aligning care delivery with population health strategies, risk-based contracts, and quality performance metrics. The VP ensures high-quality, cost-effective, patient-centered care while advancing the organization’s shift from volume-based to value-based reimbursement.
Key Responsibilities
Strategic Leadership (Value-Based Care)
Education
Vice President of Primary Care Operations
The Vice President of Primary Care Operations is a senior executive responsible for leading the transformation and performance of primary care services within a value-based care model. This role drives clinical, operational, and financial outcomes by aligning care delivery with population health strategies, risk-based contracts, and quality performance metrics. The VP ensures high-quality, cost-effective, patient-centered care while advancing the organization’s shift from volume-based to value-based reimbursement.
Key Responsibilities
Strategic Leadership (Value-Based Care)
- Lead the design and execution of a value-based care strategy across all primary care operations.
- Align primary care services with population health goals, including risk stratification, preventive care, and chronic disease management.
- Partner with payer organizations to optimize performance in risk-based and shared savings contracts.
- Drive growth in attributed lives and manage total cost of care (TCOC).
- Oversee multi-site primary care operations with a focus on care model transformation (team-based care, care coordination, integrated behavioral health).
- Standardize workflows that support value-based care delivery, including care gap closure and utilization management.
- Implement and scale care management programs for high-risk populations.
- Manage financial performance under value-based arrangements, including shared savings, capitation, and bundled payments.
- Monitor key metrics such as total cost of care, medical loss ratio (MLR), and risk adjustment accuracy (RAF scoring).
- Collaborate with finance and analytics teams to ensure accurate forecasting and performance tracking.
- Drive performance on quality measures (e.g., HEDIS, STAR ratings, CMS quality programs).
- Partner with clinical leadership to improve outcomes in chronic disease management, preventive care, and care transitions.
- Ensure compliance with regulatory and payer-specific quality requirements.
- Lead initiatives to align provider incentives with value-based performance.
- Support adoption of team-based care models including care managers, pharmacists, and social workers.
- Enhance provider engagement through education on value-based care principles and performance metrics.
- Improve patient access through advanced access scheduling, telehealth, and digital tools.
- Enhance patient engagement in preventive care and chronic disease self-management.
- Address social determinants of health (SDOH) impacting patient outcomes.
- Leverage data analytics to identify care gaps, manage population health, and drive decision-making.
- Oversee optimization of EHR and population health platforms to support value-based care workflows.
- Promote interoperability and data sharing across the care continuum.
- Collaborate with payers, ACOs, and community partners to strengthen value-based care initiatives.
- Develop referral networks that support high-quality, cost-effective care.
- Represent primary care in contract negotiations and strategic partnerships.
Education
- Bachelor’s degree in Healthcare Administration, Business Administration, or related field (required)
- Master’s degree (MBA, MHA, MPH, or equivalent) strongly preferred
- 10 years of healthcare leadership experience, with significant exposure to value-based care models
- 10 years overseeing multi-site primary care or population health operations
- Demonstrated success managing risk-based contracts and improving cost and quality outcomes
- Deep expertise in value-based care, population health, and risk adjustment methodologies
- Strong financial acumen related to capitation, shared savings, and cost-of-care management
- Experience with quality frameworks (HEDIS, CMS Stars, ACO metrics)
- Proven ability to lead care model transformation and change management
- Advanced data-driven decision-making capabilities
- Total Cost of Care (TCOC) reduction
- Quality scores (HEDIS, STAR ratings, CMS measures)
- Risk adjustment factor (RAF) accuracy and documentation
- Patient access and care gap closure rates
- Shared savings performance and margin under VBC contracts
- Hospital utilization (admissions, readmissions, ED visits)
- Patient and provider satisfaction