VP of Value-Based Care Operations

4 days ago

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Theoria Medical

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Theoria Medical is a leader in tech-enabled, value-based primary care, revolutionizing healthcare for senior living communities nationwide. The company employs a fully integrated model of care, combining primary care services with the latest technological advancements to offer a holistic and impactful healthcare experience for seniors. Their innovative offerings include remote patient monitoring, medical directorship, on-site medical staff, telemedicine, and workflow optimizations, all anchored by pioneering technologies like ChartEasy, ChatEasy, and ProphEasy. Theoria Medical is committed to enhancing patient outcomes through digital innovation and serves patients in skilled nursing, assisted living, and independent living settings across the United States.

1001 - 5000 employees

⚕️ Healthcare Insurance

☁️ SaaS

📡 Telecommunications

📋 Description

• Operational Leadership in Value-Based Care • Lead the operational execution of Theoria Medical’s value-based care strategy, ensuring alignment with CMS GUIDE Model, ACOs, Medicare Advantage, and other VBC frameworks. • Oversee key initiatives, including risk stratification, care coordination workflows, and provider engagement strategies to drive improved patient outcomes and financial performance. • Develop and manage operational performance metrics, identifying areas for process improvement, cost reduction, and quality enhancement. • Optimize patient engagement strategies to increase adherence to value-based care programs and initiatives. • Strategic Oversight of GUIDE Model & Post-Acute Care Initiatives • Partner with the VP of Clinical Operations to ensure seamless execution of GUIDE Model requirements, including care navigation and respite service implementation. • Lead cross-functional teams in data analytics, provider education, and operational efficiency efforts to enhance Theoria Medical’s position in VBC programs. • Ensure compliance with CMS and payer requirements, tracking key performance indicators (KPIs) tied to reimbursement and quality benchmarks. • Drive operational excellence in post-acute care coordination, managing provider workflows to reduce hospital readmissions and improve care transitions. • Expansion of ACO, Hospital & Payer Partnerships • Develop and execute strategies to integrate Theoria Medical’s services into value-based contracts with ACOs, Hospitals, Medicare Advantage plans, and payer networks. • Identify and engage strategic partners to position Theoria Medical as a premier post-acute care provider. • Monitor financial performance under risk-based contracts, working closely with finance and analytics teams to optimize shared savings and quality incentives. • Serve as the operational lead in contract negotiations, data reporting, and VBC program implementation. • Data-Driven Decision Making & Performance Optimization • Oversee the collection, analysis, and reporting of operational and financial data to measure the success of VBC initiatives. • Utilize predictive analytics and technology solutions to enhance care delivery, streamline workflows, and improve provider efficiency. • Develop operational best practices to enhance provider engagement, patient adherence, and overall quality performance within Theoria Medical’s VBC framework.

🎯 Requirements

• Required: Bachelor’s or Master’s degree • Preferred: Bachelor’s or Master’s degree in Healthcare Administration, Public Health, Business Administration, or a related field. • 5+ years of operational leadership experience in healthcare, with a strong emphasis on value-based care models, ACOs, or post-acute care. • Demonstrated success in developing ACO partnerships and value-based care strategies. • Deep understanding of CMS models (GUIDE, MSSP, Medicare Advantage, ACOs, and value-based reimbursement frameworks). • Experience with provider engagement and care coordination workflows in post-acute or transitional care settings.

🏖️ Benefits

• PTO • 401k with employer match • Health insurance • Employer Paid - Life Insurance Policy