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)
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Lead the design and execution of a value-based care strategy across all primary care operations.
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Align primary care services with population health goals, including risk stratification, preventive care, and chronic disease management.
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Partner with payer organizations to optimize performance in risk-based and shared savings contracts.
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Drive growth in attributed lives and manage total cost of care (TCOC).
Operational Oversight
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Oversee multi-site primary care operations with a focus on care model transformation (team-based care, care coordination, integrated behavioral health).
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Standardize workflows that support value-based care delivery, including care gap closure and utilization management.
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Implement and scale care management programs for high-risk populations.
Financial & Risk Performance
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Manage financial performance under value-based arrangements, including shared savings, capitation, and bundled payments.
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Monitor key metrics such as total cost of care, medical loss ratio (MLR), and risk adjustment accuracy (RAF scoring).
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Collaborate with finance and analytics teams to ensure accurate forecasting and performance tracking.
Quality & Clinical Outcomes
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Drive performance on quality measures (e.g., HEDIS, STAR ratings, CMS quality programs).
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Partner with clinical leadership to improve outcomes in chronic disease management, preventive care, and care transitions.
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Ensure compliance with regulatory and payer-specific quality requirements.
Provider & Care Team Enablement
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Lead initiatives to align provider incentives with value-based performance.
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Support adoption of team-based care models including care managers, pharmacists, and social workers.
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Enhance provider engagement through education on value-based care principles and performance metrics.
Patient Experience & Access
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Improve patient access through advanced access scheduling, telehealth, and digital tools.
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Enhance patient engagement in preventive care and chronic disease self-management.
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Address social determinants of health (SDOH) impacting patient outcomes.
Data, Analytics & Technology
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Leverage data analytics to identify care gaps, manage population health, and drive decision-making.
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Oversee optimization of EHR and population health platforms to support value-based care workflows.
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Promote interoperability and data sharing across the care continuum.
Partnerships & Network Development
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Collaborate with payers, ACOs, and community partners to strengthen value-based care initiatives.
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Develop referral networks that support high-quality, cost-effective care.
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Represent primary care in contract negotiations and strategic partnerships.
Qualifications
Education
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Bachelor’s degree in Healthcare Administration, Business Administration, or related field (required)
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Master’s degree (MBA, MHA, MPH, or equivalent) strongly preferred
Experience
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10+ years of healthcare leadership experience, with significant exposure to value-based care models
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10+ years overseeing multi-site primary care or population health operations
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Demonstrated success managing risk-based contracts and improving cost and quality outcomes
Skills & Competencies
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Deep expertise in value-based care, population health, and risk adjustment methodologies
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Strong financial acumen related to capitation, shared savings, and cost-of-care management
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Experience with quality frameworks (HEDIS, CMS Stars, ACO metrics)
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Proven ability to lead care model transformation and change management
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Advanced data-driven decision-making capabilities
Key Performance Indicators (KPIs)
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Total Cost of Care (TCOC) reduction
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Quality scores (HEDIS, STAR ratings, CMS measures)
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Risk adjustment factor (RAF) accuracy and documentation
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Patient access and care gap closure rates
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Shared savings performance and margin under VBC contracts
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Hospital utilization (admissions, readmissions, ED visits)
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Patient and provider satisfaction
Qualifications
Education
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Bachelor’s degree in Healthcare Administration, Business Administration, or related field (required)
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Master’s degree (MBA, MHA, MPH, or equivalent) strongly preferred
Experience
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10+ years of healthcare leadership experience, with significant exposure to value-based care models
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10+ years overseeing multi-site primary care or population health operations
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Demonstrated success managing risk-based contracts and improving cost and quality outcomes
