Senior Vice President, Value- Care - Population Health, Risk & Quality

Improve the lives of others while Caring. Connecting. Growing together.

Job Description - Senior Vice President, Value-Based Care – Population Health, Risk & Quality (2361725)

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.

Come make an impact on the communities we serve as you help us advance health optimization on a global scale.

The Senior Vice President, Value-Based Care is an enterprise executive accountable for end-to-end performance across population health, risk adjustment, quality and medical expense (affordability). This role integrates strategy and execution to deliver superior clinical outcomes, revenue integrity and total cost of care performance across all markets and lines of business.

The Senior Vice President leads a comprehensive value-based care operating model spanning risk capture, quality performance, utilization management, network optimization and cost management, ensuring aligned execution across clinical, operational, financial and analytic functions. This leader drives measurable improvement in affordability, provider performance and member outcomes through scaled operating rigor, standardized processes and market accountability.

• Deliver Performance:
  Achieve sustained improvement in total cost of care, risk score accuracy and quality outcomes across markets
• Integrate Value-Based Model:
  Align risk, quality and medical expense strategies into a unified, enterprise operating framework
• Drive Affordability:
  Reduce unnecessary utilization, cost leakage and variation while improving care coordination and outcomes
• Ensure Compliance & Integrity:
  Maintain audit-ready, compliant operations across risk adjustment, coding and quality programs
• Scale Execution:
  Standardize processes and enable consistent, high-performing execution across markets and provider networks
• Lead Enterprise Influence:
  Align executive stakeholders across clinical, finance, actuarial, operations and analytics to achieve shared outcomes

• Define and lead the enterprise strategy for population health, risk adjustment, quality and affordability
• Translate strategy into operating plans, KPIs and performance targets across regions and markets
• Establish a rigorous operating cadence (performance reviews, deep dives, escalation pathways) to drive accountability and results
• Ensure alignment between enterprise priorities and market execution, balancing standardization with local flexibility
• Own enterprise strategy and execution for risk adjustment programs, ensuring complete, accurate and compliant risk capture
• Oversee prospective, concurrent and retrospective workflows, enabling provider adoption and documentation excellence
• Ensure solid controls, submission accuracy and audit readiness across all risk activities
• Partner with finance and actuarial teams to manage forecasting, accruals and revenue validation

• Lead enterprise quality strategy and performance improvement aligned to payer and regulatory programs (e.g., Stars, HEDIS, CAHPS)
• Drive measure closure, clinical gap closure and patient experience outcomes across markets
• Establish consistent quality governance, reporting and intervention frameworks to improve reliability and reduce variation

• Drive enterprise performance across medical expense, utilization and affordability metrics
• Lead initiatives to optimize:
  • Inpatient utilization (bed days, length of stay, readmissions)
  • Emergency and avoidable utilization
  • Post-acute, specialty and site-of-care optimization
• Reduce cost leakage through improved referral management, network alignment and utilization controls
• Deliver measurable ROI and sustained cost reduction…