Senior Vice President, Value-Based Care – Population Health, Risk & Quality Remote (anywhere in California) + 8 more

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Senior Vice President, Value-Based Care is an enterprise executive accountable for end-to-end performance across population health, risk adjustment, quality and medical expense (affordability). This role integrates strategy and execution to deliver superior clinical outcomes, revenue integrity and total cost of care performance across all markets and lines of business.

The Senior Vice President leads a comprehensive value-based care operating model spanning risk capture, quality performance, utilization management, network optimization and cost management, ensuring aligned execution across clinical, operational, financial and analytic functions. This leader drives measurable improvement in affordability, provider performance and member outcomes through scaled operating rigor, standardized processes and market accountability.

Core Accountabilities (What Success Looks Like)

Deliver Performance: Achieve sustained improvement in total cost of care, risk score accuracy and quality outcomes across markets

Integrate Value-Based Model: Align risk, quality and medical expense strategies into a unified, enterprise operating framework

Drive Affordability: Reduce unnecessary utilization, cost leakage and variation while improving care coordination and outcomes

Ensure Compliance & Integrity: Maintain audit-ready, compliant operations across risk adjustment, coding and quality programs

Scale Execution: Standardize processes and enable consistent, high-performing execution across markets and provider networks

Lead Enterprise Influence: Align executive stakeholders across clinical, finance, actuarial, operations and analytics to achieve shared outcomes

Primary Responsibilities:

Enterprise Value-Based Care Strategy & Governance

Define and lead the enterprise strategy for population health, risk adjustment, quality and affordability

Translate strategy into operating plans, KPIs and performance targets across regions and markets

Establish a rigorous operating cadence (performance reviews, deep dives, escalation pathways) to drive accountability and results

Ensure alignment between enterprise priorities and market execution, balancing standardization with local flexibility

Risk Adjustment & Revenue Integrity

Own enterprise strategy and execution for risk adjustment programs, ensuring complete, accurate and compliant risk capture

Oversee prospective, concurrent and retrospective workflows, enabling provider adoption and documentation excellence

Ensure solid controls, submission accuracy and audit readiness across all risk activities

Partner with finance and actuarial teams to manage forecasting, accruals and revenue validation

Quality Performance & Clinical Outcomes

Lead enterprise quality strategy and performance improvement aligned to payer and regulatory programs (e.g., Stars, HEDIS, CAHPS)

Drive measure closure, clinical gap closure and patient experience outcomes across markets

Establish consistent quality governance, reporting and intervention frameworks to improve reliability and reduce variation

Medical Expense (MedEx) & Total Cost of Care Performance

Drive enterprise performance across medical expense, utilization and affordability metrics

Lead initiatives to optimize:

Inpatient utilization (bed days, length of stay, readmissions)

Emergency and avoidable utilization

Post-acute, specialty and site-of-care optimization

Reduce cost leakage through improved referral management, network alignment and utilization controls

Deliver measurable ROI and sustained cost reduction across markets

Network & Provider Performance Optimization

Partner with network, clinical and operations leaders to optimize provider performance and engagement

Improve in-network utilization, access and care coordination

Identify and address capacity constraints, referral patterns and performance gaps

Analytics, Insights & Performance Management

Establish enterprise dashboards and KPIs to monitor risk, quality, utilization and cost performance

Translate data into actionable insights, prioritized interventions and measurable outcomes

Partner with analytics teams to improve targeting, forecasting and performance transparency

Operational Excellence & Standardization

Develop and scale standard operating models, workflows and best practices across markets

Lead continuous improvement initiatives to reduce variation and improve reliability

Enable technology adoption and process optimization at scale

Compliance, Controls & Audit Readiness

Ensure adherence to regulatory requirements, coding standards and quality program guidelines

Maintain audit-ready environments (e.g., RADV, OIG) and lead response/remediation efforts

Implement solid controls, policies and monitoring frameworks to mitigate risk

Leadership & Talent Development

Build and lead high-performing, enterprise-scale teams across value-based care, risk, quality and affordability

Develop leadership bench strength, succession plans and critical capabilities

Influence and align cross-functional executive stakeholders to deliver enterprise outcomes

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

15+ years healthcare experience with significant executive leadership responsibility

10+ years of deep expertise in value-based care, population health, risk adjustment and medical expense management

Demonstrated success delivering risk, quality and cost-of-care performance at scale in complex, matrixed organizations

Solid financial, analytical and operational acumen, including forecasting, KPI management and performance optimization

Preferred Qualifications:

Experience with Medicare Advantage, risk-bearing entities or large physician networks

Expertise in Stars, HEDIS, CAHPS and regulatory/audit environments

Proven ability to standardize and scale operating models across markets

Advanced capabilities in analytics-driven performance management and transformation leadership

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $200,400 to $343,500 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.