Senior Vice President, Value-Based Care – Population Health, Risk & Quality

UnitedHealth Group•Albuquerque, NV

3d•$200,400 - $343,500

About The Position

The Senior Vice President, Value-Based Care is an enterprise executive accountable for end-to-end performance across population health, risk adjustment, quality and medical expense (affordability). This role integrates strategy and execution to deliver superior clinical outcomes, revenue integrity and total cost of care performance across all markets and lines of business. The Senior Vice President leads a comprehensive value-based care operating model spanning risk capture, quality performance, utilization management, network optimization and cost management, ensuring aligned execution across clinical, operational, financial and analytic functions. This leader drives measurable improvement in affordability, provider performance and member outcomes through scaled operating rigor, standardized processes and market accountability.

Requirements

15+ years healthcare experience with significant executive leadership responsibility
10+ years of deep expertise in value-based care, population health, risk adjustment and medical expense management
Demonstrated success delivering risk, quality and cost-of-care performance at scale in complex, matrixed organizations
Solid financial, analytical and operational acumen, including forecasting, KPI management and performance optimization

Nice To Haves

Experience with Medicare Advantage, risk-bearing entities or large physician networks
Expertise in Stars, HEDIS, CAHPS and regulatory/audit environments
Proven ability to standardize and scale operating models across markets
Advanced capabilities in analytics-driven performance management and transformation leadership

Responsibilities

Define and lead the enterprise strategy for population health, risk adjustment, quality and affordability
Translate strategy into operating plans, KPIs and performance targets across regions and markets
Establish a rigorous operating cadence (performance reviews, deep dives, escalation pathways) to drive accountability and results
Ensure alignment between enterprise priorities and market execution, balancing standardization with local flexibility
Own enterprise strategy and execution for risk adjustment programs, ensuring complete, accurate and compliant risk capture
Oversee prospective, concurrent and retrospective workflows, enabling provider adoption and documentation excellence
Ensure solid controls, submission accuracy and audit readiness across all risk activities
Partner with finance and actuarial teams to manage forecasting, accruals and revenue validation
Lead enterprise quality strategy and performance improvement aligned to payer and regulatory programs (e.g., Stars, HEDIS, CAHPS)
Drive measure closure, clinical gap closure and patient experience outcomes across markets
Establish consistent quality governance, reporting and intervention frameworks to improve reliability and reduce variation
Drive enterprise performance across medical expense, utilization and affordability metrics
Lead initiatives to optimize: Inpatient utilization (bed days, length of stay, readmissions), Emergency and avoidable utilization, Post-acute, specialty and site-of-care optimization
Reduce cost leakage through improved referral management, network alignment and utilization controls
Deliver measurable ROI and sustained cost reduction across markets
Partner with network, clinical and operations leaders to optimize provider performance and engagement
Improve in-network utilization, access and care coordination
Identify and address capacity constraints, referral patterns and performance gaps
Establish enterprise dashboards and KPIs to monitor risk, quality, utilization and cost performance
Translate data into actionable insights, prioritized interventions and measurable outcomes
Partner with analytics teams to improve targeting, forecasting and performance transparency
Develop and scale standard operating models, workflows and best practices across markets
Lead continuous improvement initiatives to reduce variation and improve reliability
Enable technology adoption and process optimization at scale
Ensure adherence to regulatory requirements, coding standards and quality program guidelines
Maintain audit-ready environments (e.g., RADV, OIG) and lead response/remediation efforts
Implement solid controls, policies and monitoring frameworks to mitigate risk
Build and lead high-performing, enterprise-scale teams across value-based care, risk, quality and affordability
Develop leadership bench strength, succession plans and critical capabilities
Influence and align cross-functional executive stakeholders to deliver enterprise outcomes