VP of Operations

Vice President of Primary Care Operations

The Vice President of Primary Care Operations is a senior executive responsible for leading the transformation and performance of primary care services within a value-based care model. This role drives clinical, operational, and financial outcomes by aligning care delivery with population health strategies, risk-based contracts, and quality performance metrics. The VP ensures high-quality, cost-effective, patient-centered care while advancing the organization’s shift from volume-based to value-based reimbursement.

Key Responsibilities

Strategic Leadership (Value-Based Care)

• Lead the design and execution of a value-based care strategy across all primary care operations.
• Align primary care services with population health goals, including risk stratification, preventive care, and chronic disease management.
• Partner with payer organizations to optimize performance in risk-based and shared savings contracts.
• Drive growth in attributed lives and manage total cost of care (TCOC).

Operational Oversight

• Oversee multi-site primary care operations with a focus on care model transformation (team-based care, care coordination, integrated behavioral health).
• Standardize workflows that support value-based care delivery, including care gap closure and utilization management.
• Implement and scale care management programs for high-risk populations.

Financial & Risk Performance

• Manage financial performance under value-based arrangements, including shared savings, capitation, and bundled payments.
• Monitor key metrics such as total cost of care, medical loss ratio (MLR), and risk adjustment accuracy (RAF scoring).
• Collaborate with finance and analytics teams to ensure accurate forecasting and performance tracking.

Quality & Clinical Outcomes

• Drive performance on quality measures (e.g., HEDIS, STAR ratings, CMS quality programs).
• Partner with clinical leadership to improve outcomes in chronic disease management, preventive care, and care transitions.
• Ensure compliance with regulatory and payer-specific quality requirements.

Provider & Care Team Enablement

• Lead initiatives to align provider incentives with value-based performance.
• Support adoption of team-based care models including care managers, pharmacists, and social workers.
• Enhance provider engagement through education on value-based care principles and performance metrics.

Patient Experience & Access

• Improve patient access through advanced access scheduling, telehealth, and digital tools.
• Enhance patient engagement in preventive care and chronic disease self-management.
• Address social determinants of health (SDOH) impacting patient outcomes.

Data, Analytics & Technology

• Leverage data analytics to identify care gaps, manage population health, and drive decision-making.
• Oversee optimization of EHR and population health platforms to support value-based care workflows.
• Promote interoperability and data sharing across the care continuum.

Partnerships & Network Development

• Collaborate with payers, ACOs, and community partners to strengthen value-based care initiatives.
• Develop referral networks that support high-quality, cost-effective care.
• Represent primary care in contract negotiations and strategic partnerships.

Qualifications

Education

• Bachelor’s degree in Healthcare Administration, Business Administration, or related field (required)
• Master’s degree (MBA, MHA, MPH, or equivalent) strongly preferred

Experience

• 10+ years of healthcare leadership experience, with significant exposure to value-based care models
• 10+ years overseeing multi-site primary care or population health operations
• Demonstrated success managing risk-based contracts and improving cost and quality outcomes

Skills & Competencies

• Deep expertise in value-based care, population health, and risk adjustment methodologies
• Strong financial acumen related to capitation, shared savings, and cost-of-care management
• Experience with quality frameworks (HEDIS, CMS Stars, ACO metrics)
• Proven ability to lead care model transformation and change management
• Advanced data-driven decision-making capabilities

Key Performance Indicators (KPIs)

• Total Cost of Care (TCOC) reduction
• Quality scores (HEDIS, STAR ratings, CMS measures)
• Risk adjustment factor (RAF) accuracy and documentation
• Patient access and care gap closure rates
• Shared savings performance and margin under VBC contracts
• Hospital utilization (admissions, readmissions, ED visits)
• Patient and provider satisfaction

 

Qualifications

Education

• Bachelor’s degree in Healthcare Administration, Business Administration, or related field (required)
• Master’s degree (MBA, MHA, MPH, or equivalent) strongly preferred

Experience

• 10+ years of healthcare leadership experience, with significant exposure to value-based care models
• 10+ years overseeing multi-site primary care or population health operations
• Demonstrated success managing risk-based contracts and improving cost and quality outcomes