Lead VBC Quality Consultant

Location: Remote-MO

Position Purpose

The Lead VBC Quality Consultant serves as the strategic quality advisor for an assigned portfolio of Value-Based Care organizations. The role analyzes performance, identifies opportunities, develops quality improvement strategies, and partners with provider organizations to improve Medicare Stars, HEDIS, CAHPS, and other quality outcomes. The consultant serves as the primary quality liaison between internal teams and external provider partners and is accountable for coordinating execution, monitoring results, and escalating barriers.

Key Details: Value-Based Care experience and Medicare Quality experience highly preferred.

Manage a portfolio of approximately 8–10 VBC organizations and serve as the primary national quality contact for assigned accounts.

Establish annual, quarterly, and monthly quality priorities based on contract goals, performance trends, population needs, and identified performance risk.

Develop partner-specific quality strategies, action plans, milestones, and accountability mechanisms; monitor execution and intervene when progress is off track.

Track performance against Medicare Stars, HEDIS, CAHPS, medication adherence, clinical quality, member experience, and applicable VBC quality goals.

Analyze provider-, measure-, and member-level data to identify performance drivers, care-gap opportunities, emerging risks, and variation across markets or provider groups.

Translate complex findings into focused initiatives that improve gap closure, medication adherence, preventive care, chronic condition management, and member experience.

Assess intervention effectiveness, recommend course corrections, and share scalable best practices across the VBC portfolio.

Support performance forecasting, executive reporting, and prioritization of high-impact measures and populations.

Partner with Market Quality, Network, Provider Engagement, Analytics, Pharmacy, Risk Adjustment, Clinical Operations, Data/EMR teams, and leadership to align strategy and execution.

Lead or contribute to cross-functional workgroups that address performance barriers, data issues, provider workflow needs, and enterprise quality priorities.

Bring provider insights and recurring barriers back to internal teams to inform national strategy, resource allocation, and process improvement.

Performs other duties as assigned.

Complies with all policies and standards.

Education/Experience

Bachelor's Degree Nursing, Public Health, Healthcare Administration, Business Administration, or related field, or equivalent relevant experience. required

Additional Locations: Remote-FL