Director of Value Based Care

Job Summary

PRG's Value-Based Care Platform brings together two complementary service lines — Remote Patient Monitoring and Chronic Care Management — that serve patients across hundreds of practices nationwide. Together they represent one of the company's most exciting growth opportunities, with strong clinical foundations, deep practice relationships, established reimbursement fluency across the Medicare value-based care code stack, and meaningful runway for expansion across patient populations and provider partners.

The Director of Value-Based Care Platform is the senior operational leader of this combined business. The role owns the platform direction, supplier and vendor relationships, operational scale and team development, device fulfillment and logistics, and the development of new value-based care service offerings as the regulatory environment continues to expand. The Director collaborates closely with the clinical leadership of our VBC programs — who own clinical protocols, patient criteria, and regulatory compliance — and with our R&D engineering team on platform capabilities.

This is a high-impact role with operational ownership of a growing business line and meaningful budget responsibility. It is an operations and platform role, not a clinical leadership role; the right candidate is someone who has scaled tech-enabled healthcare services, built supplier and logistics operations, and worked effectively in partnership with clinical co-leaders.

Responsibilities

Operational Leadership & Scale

• Lead the operations team across patient enrollment, care coordination, tech support, eligibility, and billing functions. Develop the team, set performance expectations, and grow operational leadership over time.
• Design the operational scaling strategy for the line of business, balancing selective hiring with thoughtful workflow design and automation so that the cost-to-serve improves as patient volume grows.
• Establish operational KPIs and unit economics tracking for the line of business — productivity metrics, patient outcomes, fulfillment cycle times, cost-to-serve, and business unit performance — and report regularly to senior leadership.
• Build the customer experience for our practice partners and their patients, including the tech support model that supports both providers and end users.
• Drive continuous productivity improvement across the care coordinator and operations teams through better tooling, refined workflow design, and intelligent use of automation.
• Partner with the Business Operations & Intelligence (BOI) department on dashboards, performance analytics, and operational automation initiatives that improve insight quality and operational efficiency.

Supply Chain, Logistics & Procurement

• Manage end-to-end device logistics across procurement, inventory, fulfillment to patients, returns, and reverse logistics. Establish and continuously improve the inventory management system as device volume grows.
• Build and manage supplier relationships with cellular and bluetooth device manufacturers, contactless monitoring vendors, and logistics partners. Negotiate pricing, SLAs, warranty terms, and replacement economics.
• Lead the rollout of new device categories and emerging monitoring technologies as the program expands beyond its current device mix.
• Own the device retrieval and reverse logistics workflow for patients exiting the program, ensuring devices are returned, accounted for, and refurbished or retired efficiently.
• Develop fulfillment processes that scale to multi-thousand-patient enrollment growth without proportional headcount expansion.
• Continuously evaluate the cost structure and competitive landscape of the device and platform vendor ecosystem; recommend supplier consolidation or expansion as the business grows.

Platform Strategy & Technology

• Own platform strategy for the VBC line of business — including device integration, patient engagement, clinical workflow support, billing handoff, and EHR interoperability. Translate business and operational needs into platform priorities.
• Lead a platform direction review in the first 60–90 days, including assessment of build-versus-buy options, partnerships with established VBC platforms in the market, and the optimal mix of in-house R&D investment and external partnership.
• Partner with the R&D team on the platform development roadmap. R&D's in-house software development and AI engineering capability is a core asset of the line of business, and the Director shapes how that capability is directed toward VBC.
• Drive bi-directional EHR integration priorities with the systems used most commonly by our practice base — including eClinicalWorks, AdvancedMD, Athena, Epic, NextGen, and CareCloud — to enable real-time eligibility, alerting, and bi-directional documentation.
• Define automation requirements for patient outreach, including automated voice, SMS engagement, and intelligent contact sequencing — alongside the care coordination teams that own the clinical conversations.
• Partner with the offshore engineering team in India and Pakistan on platform development and technical capacity planning. Coordinate with BOI on shared analytics and automation infrastructure.
• Drive platform reliability, scalability, and security in partnership with the IT and CyRx360 functions, ensuring HIPAA, HITRUST, and SOC 2 alignment as the platform grows.

Partnership with Clinical Leadership

• Patient eligibility criteria, ICD code mapping, comorbidity exceptions, and exclusion criteria.
• Clinical escalation thresholds (AHA-aligned ranges, hypertensive crisis protocols, individualized baselines, and special-population considerations).
• Care plan structure, documentation language, time documentation requirements, and clinical oversight standards.
• Patient contact rule sequencing and the clinical logic governing patient transitions across program states.
• HIPAA and CMS compliance posture, including documentation standards required for CPT 99453/99454/99457/99458 reimbursement and audit defense.
• Clinical staff training content and clinical quality oversight of the care coordination team.

New Service Development & Market Expansion

• Partner with clinical leadership on new service design — clinical leadership defines protocol, the Director leads on platform, operational, and commercial design.
• Identify expansion opportunities into Accountable Care Organizations, Medicare Advantage plans, risk-bearing entities, and health system partnerships.
• Develop concurrent multi-program billing capability (Remote Patient Monitoring Chronic Care Management Remote Therapeutic Monitoring Behavioral Health Integration for the same patient where qualifying).
• Stay current on CMS regulatory updates, reimbursement changes, and competitive offerings; brief leadership on material strategic implications.
• Represent the VBC line of business in executive committee discussions and selected industry conferences and partnership conversations.

Job Information

Full-time: On-site/Hybrid

Travel: 5-10% (Client visits, vendor meetings, professional development)

Compensation: 120,000 - 150,000 10-15% annual bonus (based on operational performance)

Qualifications

Required

• 5–7 years of progressive leadership experience spanning healthcare operations, value-based care, or tech-enabled services.
• Direct experience leading or scaling a tech-enabled services operation, ideally in a healthcare context.
• Operational experience in logistics, supply chain, or device fulfillment at scale — including procurement, vendor management, and reverse logistics.
• Procurement and vendor management experience, including direct negotiation of multi-year commercial agreements with hardware suppliers, software platforms, or service partners.
• Working knowledge of CMS value-based care reimbursement programs (CCM, RPM, RTM, BHI, MACRA, MIPS) and how they monetize at the patient and practice level.
• Demonstrated ability to scale operations through a combination of automation and selective hiring, rather than headcount alone.
• Demonstrated cross-functional leadership and effective partnership with clinical leaders.
• Operational ownership of a meaningful healthcare services function with direct budget responsibility.
• Bachelor's degree required.

Preferred

• Advanced degree (MBA, MHA, MPH, or similar).
• Prior experience scaling a remote patient monitoring, chronic care management, or value-based care platform business.
• Direct experience in a peer-partnership structure with a clinical co-leader.
• Prior P&L responsibility for a healthcare services line of business.
• Direct experience operating within or alongside an ACO, risk-bearing entity, or Medicare Advantage plan vendor.
• Experience with device manufacturer ecosystems (cellular-enabled devices, bluetooth devices, integrated hubs).
• Experience launching new healthcare service lines from concept to revenue.
• Experience operating across U.S., India, and Pakistan time zones.