Director, Affordability

Director, Affordability

Alpine Physician Partners | Remote-Flexible

This role is responsible for owning and driving Alpine's medical expense reduction program across all markets. Working in close partnership with the Chief Clinical Officer, you will take clinical programs from concept through full operational deployment; help build, support and manage a portfolio of clinical and operational interventions; lead vendor selection and performance management; and construct the measurement infrastructure to track both program execution progress and financial impact at the program and PMPM (patient/membership) level.

• Med Ex framework ownership. In partnership with the Chief Clinical Officer, develop and maintain a framework for identifying, sizing, prioritizing, and implementing interventions that drive PMPM medical expense reduction across the full member population.

• Vendor programs and management. Lead vendor evaluation, selection, contracting, and ongoing performance management with Alpine vendors designed to accelerate and appropriately manage/reduce unnecessary medical spend. Hold vendors accountable to real-world admission reduction benchmarks. Where appropriate, interface with internal technology team to ensure appropriate technology specifications and safeguards have been evaluated and implemented.

• Chronic and complex disease management, Advanced life and palliative care planning, and Hospice-appropriate care. Own and drive clinical program deployment across Alpine's advanced illness portfolio, including hospice, palliative care, and disease management programs such as CHF and complex chronic condition management. Lead programs through the full lifecycle: clinical design, clinician and site engagement, patient identification and activation, vendor acceleration where applicable, and ongoing performance management.
  
  Ensure clinic-level workflows and patient touchpoints are operational, not just contracted.

• Hospital divergence and ED diversion. Design and manage programs to reduce avoidable admissions, readmissions and ED utilization in partnership with regional operations leads and clinic teams.

• Referral integrity and specialty utilization. Partner with Market CMOs and clinic teams to implement referral integrity review at the point of order, ensuring appropriate use of specialty referrals, differential utilization of high-value and in-network specialist, optimizing internal and curb-side consultation when appropriate routing, and ultimately reducing unnecessary specialty spend. Where appropriate, support in the JOC (joint operating committee) meetings with network specialists, and/or support the financial modeling of alternative payment strategies such as sub-capitation of the high-value and in-network specialists.

• Program KPI framework, ROI tracking, and cross-functional reporting:
  Working with business analytics team, serve as the business owner (along with the Chief Clinical Officer) to own Alpine's Med Ex measurement and reporting infrastructure, with a two-layer reporting cadence: (1) leading indicators of program execution—enrollment velocity, clinician activation rates, vendor milestone adherence, patient touchpoint completion—that signal whether programs are on track before financial results materialize; and (2) lagging financial impact measures—intervention-level PMPM savings, program ROI, utilization rate trends (admissions, ED visits, SNF days), and cost-per-member-per-program.
  
  Partner with IT/Data and Business Analytics to build the data infrastructure and with Finance to validate methodology and integrate into board- and investor-facing performance reporting.

• Demonstrated track record driving medical cost improvement in a full-risk Medicare Advantage or value-based care setting; experience with both plan-side affordability programs and provider-side utilization management is a strong differentiator

• Demonstrated ability to drive clinical programs from concept to live operations, including engaging clinicians and site teams, activating patients, managing vendor partnerships to accelerate program maturity, and delivering against defined…