VP, Cost of Care Performance
About The Position
Key Responsibilities Enterprise Clinical & Cost of Care Strategy Define and lead the multi-year specialty clinical strategy to optimize total cost of care performance within sub-capitated and risk-based partnerships. Establish enterprise frameworks for specialty program design, performance governance, and financial accountability. Partner with Finance and Actuarial teams to align clinical initiatives with medical cost trend targets, margin objectives, and long-range financial plans. Serve as executive sponsor for Renal, Oncology, and Palliative Care strategies, ensuring measurable impact on utilization, quality, and risk-adjusted performance. Risk & Sub-Capitated Performance Oversight Oversee enterprise performance of sub-capitated specialty programs, including reconciliation, contract adherence, and margin optimization. Implement standardized operating models, dashboards, and governance structures to ensure disciplined execution and transparency. Drive continuous improvement initiatives focused on utilization management, site-of-care optimization, and high-cost case management. Identify emerging risk trends and proactively design mitigation strategies. Provider Incentive & Alignment Strategy Architect enterprise physician incentive models that align clinical outcomes, quality performance, specialty cost management, and engagement in value-based care. Oversee operational execution of incentive measurement, attribution, and reconciliation in partnership with Finance and Market Operations. Advance physician engagement strategies that strengthen adoption of specialty clinical pathways and evidence-based protocols. Cross-Functional & Market Leadership Lead cross-functional collaboration across Finance, Technology, Quality, Medical Affairs, Business Optimization & Integration (BOI), and Market Operations to ensure integrated program deployment. Provide executive guidance to markets on specialty program implementation, scalability, and performance remediation. Foster best-practice dissemination across markets through governance forums, clinical councils, and knowledge-sharing platforms. Serve as a senior representative of agilon’s clinical and cost of care strategy in executive, board-level, and external partnership discussions. Growth & Innovation Support new market development and partnership strategy by shaping specialty cost models and clinical integration frameworks. Identify opportunities for innovation in specialty risk management, alternative payment models, and care delivery redesign. Contribute to enterprise strategic planning and long-term value-based care roadmap development.
Requirements
- 15+ years of progressive leadership experience in healthcare delivery, managed care, value-based care, or risk-bearing organizations.
- Deep expertise in specialty cost management, sub-capitated arrangements, and global risk economics.
- Demonstrated experience leading enterprise-scale clinical transformation initiatives.
- Strong financial acumen with the ability to connect clinical strategy to margin performance and total cost of care outcomes.
- Proven success influencing executive stakeholders and physician leaders in highly matrixed organizations.
- Bachelor’s degree required; advanced degree strongly preferred (MBA, MPH, MHA, MD, DO, RN, or equivalent).
- Enterprise thinker with the ability to balance strategy and execution.
- Executive presence with board-level communication capability.
- Data-driven decision maker with strong performance management orientation.
- Skilled in change leadership and physician alignment within value-based models.
- Collaborative, outcomes-focused, and mission-driven.
Nice To Haves
- Experience working with high-risk, high-complexity senior populations strongly preferred.
Responsibilities
- Define and lead the multi-year specialty clinical strategy to optimize total cost of care performance within sub-capitated and risk-based partnerships.
- Establish enterprise frameworks for specialty program design, performance governance, and financial accountability.
- Partner with Finance and Actuarial teams to align clinical initiatives with medical cost trend targets, margin objectives, and long-range financial plans.
- Serve as executive sponsor for Renal, Oncology, and Palliative Care strategies, ensuring measurable impact on utilization, quality, and risk-adjusted performance.
- Oversee enterprise performance of sub-capitated specialty programs, including reconciliation, contract adherence, and margin optimization.
- Implement standardized operating models, dashboards, and governance structures to ensure disciplined execution and transparency.
- Drive continuous improvement initiatives focused on utilization management, site-of-care optimization, and high-cost case management.
- Identify emerging risk trends and proactively design mitigation strategies.
- Architect enterprise physician incentive models that align clinical outcomes, quality performance, specialty cost management, and engagement in value-based care.
- Oversee operational execution of incentive measurement, attribution, and reconciliation in partnership with Finance and Market Operations.
- Advance physician engagement strategies that strengthen adoption of specialty clinical pathways and evidence-based protocols.
- Lead cross-functional collaboration across Finance, Technology, Quality, Medical Affairs, Business Optimization & Integration (BOI), and Market Operations to ensure integrated program deployment.
- Provide executive guidance to markets on specialty program implementation, scalability, and performance remediation.
- Foster best-practice dissemination across markets through governance forums, clinical councils, and knowledge-sharing platforms.
- Serve as a senior representative of agilon’s clinical and cost of care strategy in executive, board-level, and external partnership discussions.
- Support new market development and partnership strategy by shaping specialty cost models and clinical integration frameworks.
- Identify opportunities for innovation in specialty risk management, alternative payment models, and care delivery redesign.
- Contribute to enterprise strategic planning and long-term value-based care roadmap development.
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What This Job Offers
Job Type
Full-time
Career Level
Executive
