Note: The job is a remote job and is open to candidates in USA. Vitae Health Systems is hiring a VBC Program Manager to build and run the operating cadence of its LEAD ACO. The role leads the VBC operations team, tracks alignment, utilization, quality, and compliance, and coordinates performance reviews and improvement actions across clinical, operational, and data teams.
Responsibilities
- Run the weekly team huddle and monthly performance review covering alignment, utilization, quality, and reported spend, using KPIs and targets set by VBC leadership
- Track performance against the LEAD quality measures and Prevention and Quality Plan milestones, and report variances to leadership
- Monitor utilization drivers (admissions, readmissions, ED visits, post-acute stays) and confirm high-risk patients have a named owner and documented action, escalating gaps to clinical leadership
- Review operational CMS reports and data feeds monthly, flag variances early, and escalate risks with a recommended path
- Maintain the master calendar of CMS deadlines and deliverables, with a named owner for each, and follow up so nothing is missed
- Oversee the voluntary alignment program against leadership-set targets and deadlines, including a documented pre-submission review before each CMS submission
- Oversee reconciliation of CMS alignment lists to census and EHR data, and lead root cause reviews on avoidable attrition (deaths, hospice elections, moves, Medicare Advantage enrollment)
- Reconcile Participant and Preferred Provider lists to HR and credentialing records at the TIN/NPI level, escalating any change that needs a leadership or Compliance decision
- Verify that beneficiary notifications and outreach activities are completed, tracked, and documented to CMS requirements, in partnership with Compliance
- Work with operations managers on how VBC activities are scheduled and delivered at the facility and NP level, surfacing barriers early and avoiding unnecessary burden
- Partner with VBC clinical leadership so workflows, checklists, and handoffs reflect clinical standards
- Support development of provider-facing materials (scorecards, tip sheets, trainings) with the clinical and data owners, coordinating timelines and operational input
- Submit and sequence reporting requests to the VBC data resource through a single intake, review data for reasonableness before use in reviews, and flag manual work that could be automated
- Prepare the performance summaries the Director of VBC Operations presents to senior leadership and ACO governance, aggregating data, clinical, and operational input
- Lead root cause reviews when measures move off target and turn findings into action plans with named owners and due dates, tracking each to closure and routing clinical actions to clinical leadership
- Facilitate a quarterly improvement cycle (plan, do, study, act) based on financial and performance results, with the Director of VBC Operations as sponsor: convene Finance, clinical, and data partners to select opportunities, assign actions, evaluate results, and document learning in a VBC operating playbook
- Lead the VBC operations team and serve as its first point of contact: coach, set priorities and escalation thresholds, build SOPs with process owners, and resolve operational questions and blockers within defined boundaries, escalating strategic, financial, compliance, and policy matters to the Director of VBC Operations
- Provide input to the Director of VBC Operations on structure and staffing as scope grows
Skills
- Bachelor's degree in healthcare administration, public health, business, nursing, or a related field
- 4+ years in value-based care, ACO operations, or population health
- Direct experience in a CMS ACO model (ACO REACH, especially High Needs, MSSP, or LEAD)
- Experience in post-acute, SNF, or long-term care
- 2+ years managing staff
- Track record running recurring operating cadences and hitting deadlines
- Experience running structured improvement cycles (e.g., PDSA, Lean) and building playbooks
- Working knowledge of CMS alignment (claims-based and voluntary), ACO quality measures, beneficiary protections and marketing requirements, and benchmark and settlement basics
- Ability to drive follow-through across clinical, operational, and data teams without direct authority
- Clear communicator who can explain data to clinicians and leaders, and is comfortable with financial and utilization reports, Excel, BI dashboards, and EHR data
- Provider-side
- Understanding of NP-led care teams
- Clinical background (e.g., RN)
- Master's degree
Benefits
- Health Care Plan (Medical, Dental & Vision)
- Retirement Plan (401k, IRA)
- Life Insurance (Basic, Voluntary & AD&D)
- Paid Time Off (Vacation, Sick & Public Holidays)
- Family Leave (Maternity, Paternity)
- Short Term & Long Term Disability
- Training & Development
- Work From Home
- Free Food & Snacks
- Wellness Resources
Company Overview