Vytalize Health

Senior Director of VBC Finance

Vytalize Health

full-time

Posted on:

Location Type: Remote

Location: United States

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Job Level

Senior

About the role

  • 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
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
healthcare financevalue-based care contractingpayer economicsfinancial reportingaccounting entriesmonth-end close processesdata analysisbudgetingperformance monitoringcontract evaluation
Soft Skills
analytical skillscommunication skillspresentation skillscross-functional collaborationstrategic insightsproblem-solvingleadershipinterpersonal skillsorganizational skillsstakeholder engagement
Certifications
CPAMBA