EVP – Strategy and Portfolio — Care-Delivery Network

The mandate

A care-delivery network must decide within months which payer contracts, service lines and community partnerships it can sustain. Several contracts reward throughput, others place episodes or populations at risk, and uncompensated demand is rising in pathways with limited specialist capacity. The EVP – Strategy and Portfolio appointment has been authorised because annual planning no longer resolves the trade-offs quickly enough.

Approximately 950 employees and material partners support ambulatory, procedural, post-acute and digitally enabled services in Boston and connected US markets. The EVP reports to the Group Chief Executive or nominated sponsor and will own portfolio strategy, payer scenario analysis, strategic transactions, partnerships and enterprise planning. Finance owns the ledger; clinical leaders own care standards; this role integrates their evidence into choices the executive committee can actually make.

The first deliverable is a payer map based on economics and obligations, not contract labels. The team will model attributed populations, utilisation, risk corridors, quality measures, authorisation, leakage and payment timing. Historical contribution cannot be projected unchanged where acuity or benefit design has moved. Each scenario should identify which operating intervention management can control and which exposure must be priced, limited or declined.

Service-line strategy will consider the whole pathway. A low-margin access service may protect downstream continuity and prevent avoidable emergency use; a profitable procedure may consume scarce follow-up capacity or depend on unreimbursed coordination. The EVP will expose these linkages and recommend where to grow, redesign, partner or exit. Conclusions require patient, clinical and workforce consequences alongside financial return.

Site choices need comparable evidence. Some locations have unused physical capacity but weak referral density; others have high demand and constrained workforce. Lease cost alone cannot determine consolidation. The strategy will evaluate travel, community access, referral behaviour, licensure, equipment, transfer patterns and the time required to redirect demand safely.

The network wants fewer bespoke payer promises. Commercial teams have accepted variations in reporting, access windows and clinical programmes that burden operations beyond their price. The EVP will establish a contract architecture distinguishing standard, configurable and exceptional components. Exceptions need an explicit owner, incremental cost and expiry or renewal decision.

Partnerships may solve gaps more intelligently than ownership. Community providers, physician groups, diagnostics, home-care organisations and technology vendors can extend reach, but only if responsibility at hand-off is clear. The EVP will create partnership theses that cover clinical accountability, data, economics, continuity and exit. A referral agreement without outcome visibility is not a strategic pathway.

Capital allocation will follow portfolio conviction. The role will rank growth investments, digital capability, equipment and site moves against common scenarios. Options that preserve flexibility may outrank a larger irreversible build while payer negotiations remain open. Strategy must state what will stop or lose funding, not simply add new priorities to the current plan.

The EVP will lead selective transaction evaluation. Acquisitions should contribute capability, geography or pathway control that cannot be built or partnered effectively. Diligence must include credentialling, workforce dependence, coding, referral concentration, quality, interoperability and payer change-of-control. Revenue synergy unsupported by named referral behaviour will not enter the investment case.

Access and equity considerations are material. Portfolio decisions can shift travel, language support or digital burden onto patients. The EVP will work with clinical and community leaders to identify affected populations and mitigation. The network is not expected to solve every unmet need, but it must understand and govern the consequences of its choices.

Enterprise planning will move from presentation cycles to decision dates. A small strategy office will maintain hypotheses, evidence gaps, dependencies and owners. Each major recommendation should state what would falsify it and when the choice must be revisited. The EVP is expected to close debates, not protect optionality indefinitely.

Communication with the board must acknowledge uncertainty without becoming indecisive. Payer negotiations, regulatory changes and competitor moves will never be fully known. The role will show ranges, triggers and reversible steps, then recommend a course. Success is a coherent portfolio with operating commitment rather than a sophisticated model that nobody owns.

What you will own

• Payer, service-line, site and partnership portfolio strategy.
• Enterprise scenarios and explicit resource choices.
• Contract architecture and exception economics.
• Strategic transaction thesis and commercial diligence.
• Pathway, community and access consequence analysis.
• Capital prioritisation with finance and operations.
• Board decision papers and strategic tracking.
• Strategy leadership, capability and succession.

The first 12 months

In the first 45 days, reconstruct payer and service-line scenarios, identify irreversible decision dates and surface contracts whose operating burden is not priced. Bring immediate recommendations for negotiations already in flight.

By month six, agree the target portfolio, contract architecture and priority site or partnership moves. Reallocate capital and management capacity away from activities outside the thesis.

At twelve months, improve risk-adjusted contribution from repriced or redesigned contracts by 300 basis points, reduce unpriced contract exceptions by 50% and release at least USD 45 million from deferred, exited or restructured portfolio commitments. Every retained service line should have a board-agreed role, measurable pathway contribution and named operating owner.

What the sponsor will examine

• Payer scenarios built from utilisation and contract mechanics.
• Service choices reflecting total pathway consequences.
• Exceptions priced, governed and deliberately renewed.
• Capital visibly removed from lower-conviction activity.
• Partnerships defining accountability at clinical hand-offs.
• Decisions made by deadlines despite residual uncertainty.

The person

You bring 22–28 years across healthcare strategy, payer economics, care delivery, transactions or portfolio leadership. Recent work should include executive authority over a multi-site provider portfolio and direct negotiation or redesign of risk-bearing and fee-for-service relationships in the United States.

You can move between actuarial assumptions, clinical pathway evidence, community access and capital return without collapsing one into another. A strategy recommendation you personally drove should have resulted in a real investment, exit, contract change or partnership with measured consequences. This permanent role is onsite in Boston because the reset requires daily executive decisions.

Compensation and terms

Base compensation is USD 360,000–480,000 plus annual incentive and long-term participation linked to portfolio value, contract economics, access, capital reallocation and decision velocity. The permanent position is onsite in Boston and reports to the Group Chief Executive or nominated executive-committee sponsor. The search is urgent because contract and capital deadlines are active.

Confidentiality

The care network, sites, payers, contracts, partners, patients, portfolio models and transaction possibilities remain confidential. Disclosure follows conflict clearance and signed confidentiality. Applicants must not contact providers, payers or advisers to determine the identity of the client.