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Senior Director, Care Delivery Org – Value Based Care Contracting
Alignment Health. Develop and execute value-based contracting strategy aligned with total cost and quality goals .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in value-based contract negotiation, including full-risk and alternative payment models, while effectively managing the complete contracting cycle. Proven ability to lead cross-functional teams and align strategies with financial performance and quality goals.
Highest-signal resume keywords
Value-Based Contract NegotiationAlternative Payment ModelsMedical Claims Data AnalysisProject LeadershipCross-Functional Alignment
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Contract NegotiationContract Cycle ManagementFinancial Data AnalysisRisk-Based Contract ModelingStrategic PlanningHEDIS KnowledgeCMS Stars KnowledgeCost Improvement InitiativesProvider Relationship ManagementExecutive Summary Development
Soft Skills
LeadershipCoachingStakeholder ManagementCommunicationTeam Building
Industry Keywords
Managed CareMedicare AdvantageHealthcare ServicesValue-Based Care ModelsProvider EntitiesIPAsHealth SystemsComplex Provider SystemsGrievance & AppealsMulti-Stakeholder Projects
About the role
Key responsibilities & impact- Develop and execute value-based contracting strategy aligned with total cost and quality goals
- Design alternative payment models and negotiate high-value contracts with IPAs, large physician groups, health systems, and other provider entities
- Own the full contracting cycle from planning and document creation through negotiation, execution, and submission for loading
- Lead negotiations for complex provider contracts and facilitate external provider meetings
- Align negotiation strategy with network accessibility, quality, compliance, and financial performance goals
- Develop value-based strategic plans and oversee contract performance with targeted provider groups
- Evaluate and implement network strategic plans to achieve contracting targets and manage medical costs
- Review medical claims data, analyze cost trends, and prepare executive summaries
- Model risk-based contract scenarios and support business cases for contract structures and cost improvement initiatives
- Build, lead, and manage the MSO Contracting team
- Recruit, onboard, coach, manage performance, and retain contracting staff
- Coordinate contract support with HEDIS, Credentialing, Grievance & Appeals, SIU, and Member Services
- Lead complex, multi-stakeholder contracting projects from assessment through implementation
- Ensure project milestones, stakeholder alignment, and deliverables are completed on schedule
Requirements
What you’ll need- Minimum 10 years of related experience in value-based contract negotiation within a managed care, Medicare Advantage, or healthcare services environment
- Demonstrated track record negotiating value-based contracts with IPAs, large complex provider systems, hospitals, and large physician entities
- Expert-level negotiating skills, including full-risk, shared savings, capitation, and alternative payment models
- Experience reviewing medical claims data and developing executive summaries to mitigate medical cost trends
- Proven ability to work in a matrixed organization and drive cross-functional alignment
- Experience managing the complete contracting cycle from strategy and planning through execution and contract loading
- Bachelor's degree in Healthcare Administration, Business, Finance, or a related field; equivalent combination of professional work experience and education will be considered
- Demonstrated working knowledge of value-based care models, alternative payment methodologies, and Medicare Advantage contracting frameworks through applied experience
- Advanced value-based contract negotiation skills
- Advanced medical claims and financial data analysis skills
- Advanced alternative payment model design and strategy knowledge
- Advanced network strategy and provider relationship management skills
- Advanced cross-functional influence and stakeholder alignment skills
- Intermediate to advanced CMS Stars and HEDIS knowledge
- Advanced project and program leadership skills
Benefits
Comp & perks- Fully remote work
- Equal Opportunity/Affirmative Action employment
- Reasonable accommodations for individuals with disabilities