Executive Director of ACO & Value-Based Strategy

Bluestone delivers great outcomes by bringing exceptional care to patients living with complex, chronic conditions and disabilities. Our unique, robust model of care goes beyond primary care services — our multidisciplinary care teams collaborate with patients, their families and other healthcare providers to deliver care that is preventative, proactive and tailored to their unique needs. Using an evidence-based approach focused on quality care management and data-driven medical decisions, Bluestone care teams collaborate to manage patients’ chronic conditions, address social determinants of health, manage transitions to and from inpatient settings, provide behavioral health support and more. Under our model of care, Bluestone patients experienced 21% fewer ER visits, 36% fewer hospitalizations and 41% fewer hospital readmissions compared to patients with similar conditions and complexities over the same time period. Our care teams travel directly to patients who reside in Assisted Living, Memory Care and Group Home communities throughout Minnesota, Wisconsin and Florida and are supported by clinical operations and administrative colleagues who work remotely or at our corporate offices in Stillwater, Minnesota, and Tampa, Florida. Our success is only possible through the hard work of our employees who bring our core values of Dedication, Excellence, Collaboration and Caring to life every day. Bluestone has been named to the Star Tribune's Top Workplace list for the 14th year in a row! Bluestone also achieved Top Workplace USA 2021-2026! In 2022, Bluestone Accountable Care Organization (ACO) was the best performing ACO in the country as measured by the overall savings per Medicare beneficiary. Position Overview: The Executive Director of ACO & Value-Based Strategy serves as the strategic architect and business lead for Bluestone’s value-based care platform. Reporting directly to the CFO, this leader owns CMS program strategy, actuarial modeling, benchmark analysis, and commercial value-based contract design across all risk programs (including MSSP and ACO LEAD) and third-party affiliate relationships. Operating as an elite strategic and analytical leader, this role translates complex data into high-ROI opportunities without building an administrative operational footprint. Execution of population health, quality, and coding workflows is driven by the Chief Health Informatics Officer (CHIO), while market delivery is owned by the President of Primary Care. Schedule: Full time position Location: Salary: $210,000 - $260,000 base compensation plus bonus Responsibilities: CMS ACO Strategy & Program Administration • Own end-to-end strategy, evaluation, annual enrollment, and ongoing compliance for CMS value-based programs (MSSP, ACO LEAD, and future CMMI models). • Partner with the CFO and external actuarial resources to model financial scenarios, calculate benchmark targets, track shared savings/loss corridors, and present strategic recommendations to the CEO and Board. • Serve as the primary administrative and regulatory liaison with CMS and industry coalitions. Commercial & MSO Architecture • Structure, evaluate, and manage financial and business terms for Bluestone’s MSO/affiliate relationships, ensuring partner arrangements achieve forecasted yields. • Partner with the SVP of Growth and CSO to evaluate, design, and structure value-based arrangements (e.g., shared savings, PMPM gainshare, commercial risk) with MCOs and Medicare Advantage payers. Data Insights & Cross-Functional Alignment • Analyze clinical, financial, and actuarial data to identify high-ROI opportunities in performance, utilization, and benchmark capture. • Translate data insights into programmatic priorities, handing off technical/workflow designs to the CHIO (for HCC coding, quality, and attribution infrastructure) and field execution to Primary Care operations. • Establish key metric frameworks to track commercial and CMS risk contract performance. Qualifications: • Experience: 8+ years of progressive leadership in value-based care strategy, ACO administration, or health plan finance, with direct expertise in MSSP, ACO REACH/LEAD, or CMMI risk models. • Financial & Actuarial Rigor: Deep mastery of ACO benchmark calculations, CMS-HCC risk adjustment methodology, shared savings attribution logic, and value-based contract modeling. • Matrix Leadership: Exceptional ability to influence outcomes through collaborative handoffs across informatics, finance, and primary care operations without requiring direct operational staff build-out. • Education: Bachelor’s degree in Finance, Healthcare Administration, Business, or related quantitative field required; Master’s (MBA, MHA, MS) preferred. Bluestone Benefits: • Health Insurance • Dental Insurance • Vision Materials Insurance • Company paid Life Insurance • Company paid Short and Long-term Disability • Health Savings Account (with employer contribution) • Flexible Spending Account (FSA) • Retirement plan with 4% matching contributions • Unlimited PTO Plan