Principal Value- Care Operations Advisor

Job Description

Leads enterprise efforts supporting the design, operationalization, and optimization of value-based care programs across the full operational lifecycle. The Principal Value-Based Care Operations Advisor provides subject matter expertise spanning program design, contract execution, performance measurement, operational workflows, and financial reconciliation to ensure value-based care initiatives achieve intended clinical, financial, and operational outcomes. This role partners across clinical, network, finance, actuarial, analytics, and operational teams to translate strategic value-based care objectives into scalable operating models.

The position drives alignment across federated stakeholders and ensures programs are operationally executable, measurable, and sustainable.

• Lead end-to-end operational design of value-based care programs, including shared savings, downside risk, and alternative payment models.
• Translate strategic program objectives into operational workflows, governance structures, and execution plans.
• Identify operational gaps across contracting, attribution, performance measurement, reporting, and financial settlement processes.
• Partner with clinical, finance, actuarial, analytics, and network teams to ensure alignment between program design and operational execution.
• Support development and refinement of VBC operating models and cross-functional processes.
• Evaluate program performance drivers and recommend operational improvements to enhance outcomes and financial sustainability.
• Provide expertise supporting implementation of new reimbursement models and provider partnership strategies.
• Lead complex cross‑functional initiatives requiring coordination across enterprise stakeholders and external partners.
• Support provider engagement strategies by ensuring operational readiness and clarity of performance expectations.
• Establish repeatable processes and controls supporting program scalability and measurement integrity.
• Identify risks to program execution and develop mitigation strategies across operational domains.
• Present operational insights, performance implications, and strategic recommendations to senior leadership.
• Serve as a subject matter expert for value-based care operations and enterprise transformation initiatives.
• Mentor and guide team members supporting value-based care program delivery.

• Bachelor’s degree or advanced degree in healthcare administration, business, public health, or related field.
• 8+ years of experience in healthcare operations, value-based care programs, payer‑provider strategy, or healthcare consulting.
• Demonstrated experience supporting or operating value-based care models including total cost of care or risk-based arrangements.
• Experience working across multiple healthcare domains including clinical operations, finance, analytics, and network/provider engagement.
• Strong understanding of healthcare reimbursement and performance measurement concepts.
• In lieu of degree: 10+ years of directly related healthcare experience.

• Experience operationalizing Medicare Advantage and Commercial VBC programs.
• Experience supporting shared savings reconciliation or financial settlement processes.
• Familiarity with attribution methodologies, performance measurement frameworks, and population health analytics.
• Experience working within payer organizations or integrated delivery systems.
• Consulting or enterprise transformation experience supporting healthcare operating model design.

This role provides operational leadership ensuring value-based care strategies translate into executable and sustainable programs. The position bridges strategy and execution by aligning program design, operational workflows, and performance measurement across enterprise stakeholders. The Principal Value-Based Care Operations Advisor focuses on operational execution and program performance and does not function as a project management or reporting role.

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the…