Program Director (CMS)

About the role

The Program Director will create a vision and lead our portfolio of federal work supporting health care payment and delivery system transformation. This role will translate the federal payment innovation agenda into delivered work, including model design and payment methodology development, implementation and participant operations, engagement and learning systems, benchmark and risk adjustment analytics, and rapid-cycle monitoring.

Responsibilities

• Own delivery and growth across task orders that help federal clients design, implement, monitor, and evaluate initiatives moving the system from volume to value.
• Translate the federal payment innovation agenda into delivered work: supporting model design and payment methodology development, standing up implementation and participant operations, running engagement and learning systems that improve performance inside the model, building benchmark and risk adjustment analytics, and delivering rapid-cycle monitoring that tells the client early whether a model is on track.
• When the evidence supports scaling a model, help make the case for expansion. When it does not, help say so clearly and move resources to what works.
• Own the strategy for our value-based transformation business. Shape offerings that link payment to quality, including alternative payment model support, quality and performance measurement, risk adjustment analytics, and total cost of care work.
• Translate shifts in federal payment policy, including accountable care, primary care, specialty, prescription drug, and state-based total cost of care models, into concrete pursuit decisions.
• Lead delivery teams spanning health policy researchers, data scientists, clinicians, and program managers; own quality, schedule, and margin across the portfolio.
• Serve as the senior point of contact for federal client leadership, including contracting officers, CORs, and model teams.
• Oversee rapid-cycle evaluation and analytics workstreams, ensuring findings are rigorous, timely, and actionable for policy decisions.
• Build and manage teaming relationships with research organizations, actuarial firms, analytics shops, and specialized subcontractors.

Qualifications

• 12 or more years in federal health care consulting, research, or program delivery, with at least 5 years leading programs or portfolios for CMS or comparable federal health agencies.
• Direct experience supporting the design, implementation, or evaluation of alternative payment models or value-based purchasing programs.
• Working fluency in payment-to-quality mechanics: quality measurement, benchmarking, risk adjustment, shared savings and risk arrangements, and performance-based payment methodologies.
• Experience managing multidisciplinary teams of 25 or more, including researchers, analysts, and clinical staff.
• Familiarity with Medicare and Medicaid claims, payment, and quality data.
• Master’s degree required in public health, health policy, economics, public administration, business, or a related field; doctorate a plus.

Work Environment/Physical Demands

The work environment and physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This is a remote position. While performing the duties of this job, the employee regularly works in a remote environment. Candidates must be able to sit, read, work on a computer, and watch a computer screen for extended periods of time. Occasionally required to stand, walk, use hands and fingers, kneel or crouch.

Benefits

Commence is an equal employment opportunity employer. All personnel processes are merit-based and applied without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military and veteran status or any other characteristic protected by applicable law. Commence is committed to providing equal employment opportunities to all applicants, including individuals with disabilities. If you require a reasonable accommodation to participate in the application process due to a disability, please contact Human Resources at (757) 306-4920 or hr@commence.ai. Please note that unless you are requesting an accommodation, all applications must be submitted through our online application system.