DIRECTOR OF VALUE BASED CARE AND POPULATION HEALTH

US:NV:Carson City Population Health

Full Time Day Shift

Summary

The Director of Value-Based Care & Population Health is responsible for leading Carson Tahoe Health's population health, care coordination, utilization reduction, and value-based care initiatives in support of organizational quality, clinical performance, and financial sustainability goals.

The Director collaborates with physician leaders, case management, utilization review, quality, finance, medical group operations, and executive leadership to improve outcomes under value-based reimbursement models, including Medicare Advantage and risk-based contracts.

This position provides operational leadership for initiatives focused on reducing avoidable utilization, improving care transitions, closing care gaps, supporting risk adjustment efforts, improving patient outcomes, and advancing organizational population health strategies

Qualifications

Required:

• Bachelor's degree in Healthcare Administration, Business, or related field or equivalent combination of education and experience

• Ten (10) years experience in population health, risk-based reimbursement experience, value-based care operational leadership experience, care management and utilization management experience or related;

• Five (5) years progressively responsible experience as program lead, team lead or management

• Knowledgeable in the areas of health care delivery systems, social determinants of health and health care transformation, and have an understanding of relevant Federal and State regulatory requirements

Preferred:

• Master's degree in Nursing, Healthcare Administration or related field

Essential Functions

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• Lead operational execution of Carson Tahoe Health's population health and value-based care strategies.

• Collaborate with Case Management, Utilization Review, Quality, Medical Group Operations, and physician leadership to improve performance under value-based reimbursement arrangements.

• Support organizational initiatives focused on reducing avoidable admissions, readmissions, emergency department utilization, and total cost of care.

• Develop and implement programs targeting high-risk and rising-risk patient populations.

• Monitor population health performance metrics and recommend operational improvements based on organizational data and performance trends.

• Support care gap closure initiatives and collaborate with ambulatory operations and providers to improve preventive care and chronic disease management outcomes.

• Partner with Finance and Payer Relations to monitor value-based contract performance and identify opportunities for improvement.

• Collaborate with Medical Group Operations to support attribution strategies, patient retention efforts, and access initiatives.

• Support RAF/HCC documentation improvement initiatives in collaboration with physician leadership and ambulatory operations.

• Facilitate multidisciplinary value-based care workgroups and performance improvement initiatives.

• Prepare executive-level reports and dashboards related to population health, utilization management, care coordination, and value-based care performance.

• Monitor emerging trends in population health, Medicare Advantage, value-based reimbursement, and care management practices

• Perform other duties as assigned.

• Primary Areas of Accountability:

Population Health Strategy

• Value-Based Care Operations

• High-Risk Patient Management

• Care Gap Closure

• Readmissions Reduction

• Avoidable Utilization Reduction

• Care Coordination Initiatives

• Risk Adjustment Support

• Medicare Advantage Performance

• Population Health Analytics

• Value-Based Care Governance Coordination