VBC Program Manager

Vitae Health Systems•Park Ridge, IL

4d•$105,000 - $120,000•Remote

About The Position

The VBC Program Manager builds and runs the operating rhythm of Vitae Health Systems’ LEAD ACO, which launches January 1, 2027, building on the organization’s experience in ACO REACH High Needs. The role ensures that work driving results—including beneficiary alignment, utilization, quality performance, and program compliance—is tracked, scheduled, and completed on time. This is a hands-on operating role that leads the VBC operations team, runs weekly and monthly performance cadences with the VBC data resource, and partners with the VBC clinical team and operations managers to convert performance data into clear, prioritized actions. The position owns the calendar, cadence, and follow-through. Clinical standards and compliance decisions remain with clinical and compliance leadership. The role reports to the Director of VBC Operations and directly leads VBC Operations Coordinators and a Patient Engagement Representative. It is remote, with limited travel to facility partners and team meetings.

Requirements

Bachelor’s degree in healthcare administration, public health, business, nursing, or a related field.
4+ years in value-based care, ACO operations, or population health; provider-side experience is strongly preferred.
Direct experience in a CMS ACO model, such as ACO REACH (especially High Needs), MSSP, or LEAD.
Experience in post-acute, SNF, or long-term care.
2+ years managing staff.
Track record of running recurring operating cadences and meeting deadlines.
Experience running structured improvement cycles, such as PDSA or Lean, and building playbooks.
Working knowledge of CMS alignment (claims-based and voluntary), ACO quality measures, beneficiary protections and marketing requirements, and benchmark and settlement basics.
Ability to drive follow-through across clinical, operational, and data teams without direct authority.
Clear communication skills, including the ability to explain data to clinicians and leaders.
Comfort with financial and utilization reports, Excel, BI dashboards, and EHR data.

Nice To Haves

Understanding of NP-led care teams.
Clinical background, such as RN.
Master’s degree.

Responsibilities

Run weekly team huddles and monthly performance reviews covering alignment, utilization, quality, and reported spend, using KPIs and targets set by VBC leadership.
Track performance against LEAD quality measures and Prevention and Quality Plan milestones, and report variances to leadership.
Monitor utilization drivers, including admissions, readmissions, ED visits, and post-acute stays; confirm high-risk patients have a named owner and documented action; and escalate gaps to clinical leadership.
Review operational CMS reports and data feeds monthly, flag variances early, and escalate risks with a recommended path.
Maintain the master calendar of CMS deadlines and deliverables, assign a named owner to each, and follow up to ensure deadlines are met.
Oversee the voluntary alignment program against leadership-set targets and deadlines, including a documented pre-submission review before each CMS submission.
Oversee reconciliation of CMS alignment lists to census and EHR data, and lead root-cause reviews of avoidable attrition, including deaths, hospice elections, moves, and Medicare Advantage enrollment.
Reconcile Participant and Preferred Provider lists to HR and credentialing records at the TIN/NPI level, escalating changes requiring a leadership or Compliance decision.
Verify beneficiary notifications and outreach are completed, tracked, and documented to CMS requirements, in partnership with Compliance.
Work with operations managers on scheduling and delivery of VBC activities at facility and NP levels, surfacing barriers early and avoiding unnecessary burden.
Partner with VBC clinical leadership to ensure workflows, checklists, and handoffs reflect clinical standards.
Support development of provider-facing materials, including scorecards, tip sheets, and trainings, coordinating timelines and operational input with clinical and data owners.
Submit and sequence reporting requests to the VBC data resource through a single intake; review data for reasonableness before use in reviews; and flag manual work that could be automated.
Prepare performance summaries for the Director of VBC Operations to present to senior leadership and ACO governance, aggregating data, clinical, and operational input.
Lead root-cause reviews when measures move off target, develop action plans with named owners and due dates, track actions to closure, and route clinical actions to clinical leadership.
Facilitate quarterly plan-do-study-act improvement cycles based on financial and performance results, with the Director of VBC Operations as sponsor; convene Finance, clinical, and data partners to select opportunities, assign actions, evaluate results, and document learning in a VBC operating playbook.
Lead the VBC operations team as its first point of contact; coach staff, set priorities and escalation thresholds, build SOPs with process owners, and resolve operational questions and blockers within defined boundaries.
Escalate strategic, financial, compliance, and policy matters to the Director of VBC Operations.
Provide input to the Director of VBC Operations on team structure and staffing as scope grows.
Establish the master CMS calendar, operating cadence, escalation thresholds, initial improvement cycle, team goals, and documented workflows during the first 90 days.
Complete at least two improvement cycles during the first year, document results in a VBC operating playbook, and track alignment, quality, and utilization against targets throughout the year.