Senior Director of VBC Finance

Role Overview

• Review and evaluate active payer contracts across Medicare Advantage, Commercial, and Medicaid lines of business
• Assess contract language, risk level, shared savings / quality / PMPM terms, data specifications, financial implications, and accounting treatment
• Evaluate new contracts: analyze historical performance, model go-forward financial implications, and make recommendations
• Integrate new contracts into existing reporting, performance monitoring, and accounting processes in collaboration with payer contracting and operations teams
• Pull and consolidate payer reporting to assess contract-level financial performance (revenue, expense, MLR)
• Produce performance summaries and guidance for senior leadership and investors; escalate issues and variances as needed
• Track impact of advance cash mechanisms on revenue vs. cash treatment
• Present findings to senior executives, provider partners, and payers (e.g., provider JOC meetings, NOMS leadership)
• Actively participate in JOC and other monthly payer meetings; own performance tracking and follow-ups
• Serve as point of contact for payer-reported financial data interpretation
• Manage claims processing where applicable (e.g., Anthem MA Ohio)
• Summarize performance across all contracts and provide information flow to accounting
• Interpret payer-reported data and recommend accounting entries (revenue, COGS); propose journal entries based on reported performance
• Advise on approach to book financials given claims lag and delayed payer reporting
• Report on actuals and full-year projections as claims runout data and payer reporting become available; provide financial inputs to accounting
• Own private payer budgeting: short-term and long-term planning
• Produce and maintain budget vs. actuals reporting
• Provide strategic financial insights and contracting recommendations
• Walk through program, payer, and provider contracts with auditors
• Document revenue projection processes for in-year and future-year performance
• Assess stop-loss policies and pricing; report claims to insurance provider and manage communication for timely recoveries
• Interact with third parties (reinsurers, underwriters, actuaries) to interpret results and assess impact on performance outlook
• Provide stop-loss results to accounting
• Partner with medical economics team to analyze claims and financial data to identify savings opportunities
• Support final practice-level shared savings payouts across functions
• Serve as SME for value-based contracting across accounting, finance, data & analytics, operations, legal & compliance, and network teams
• Participate in private payer underwriting workgroup and provide input on MA incentive payment structures
• Ad-hoc participation in investor meetings to present contract financial performance and outlook
• Support claims validation and QA: data ingestion, normalization, and comparison to payer financial reporting

Requirements

• 7+ years of experience in healthcare finance, with a focus on value-based care contracting and payer economics
• Deep understanding of VBC contract structures across Medicare Advantage, Commercial, and Medicaid (shared savings, PMPM, quality, risk arrangements)
• Experience with month-end close processes, accounting entries, and financial reporting in a healthcare setting
• Strong analytical skills with the ability to synthesize complex payer data into actionable insights
• Excellent communication skills; comfortable presenting to senior executives, investors, and external partners
• Experience working cross-functionally with accounting, FP&A, operations, legal, and data teams
• Familiarity with stop-loss / reinsurance programs a plus
• Bachelor's degree in Finance, Accounting, or related field; CPA or MBA preferred

Benefits

• Competitive base compensation
• Annual bonus potential
• Health benefits effective on start date
• 401K plan effective on the first of the month after your start date; 100% of up to 4% of your annual salary
• Unlimited (or generous) paid "Vytal Time", and 5 paid sick days after your first 90 days
• Company paid STD/LTD
• Technology setup
• Ability to help build a market leader in value-based healthcare at a rapidly growing organization