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Jim Albano

Jim Albano


Jim Albano is a seasoned, strategic health care executive with extensive expertise in hospital and physician network strategies, and reimbursement innovations, coupled with a strong background in health plan operations. Jim was responsible for catalyzing the transformation of health care delivery in New Jersey from pay for volume to pay for value, with a focus on primary care population health as Vice President, Network Management, Pharmacy Services, and Healthcare Innovation Strategies for Horizon Blue Cross Blue Shield of New Jersey from 2012 until 2015, introducing shared risk and shared savings arrangements which shifted accountability to the treating physician in a significant way. During his tenure with Blue Cross Blue Shield of New Jersey, he led all operations for Horizon’s largest customer, the New Jersey State Health Benefits Program. In 2012, Jim became the public spokesperson for Horizon on population health, patient-centered medical homes, and accountable care relationships on television, print media, and with New Jersey regulators and legislators. Jim also co-chaired Horizon’s efforts to commercialize the pay-for-value arrangements by creating tiered networks and new product designs featuring these concepts. Later in 2015, Jim took on a similar role at EmblemHealth, a New York City-based health plan which had already developed full-risk relationships with key providers such as the Montefiore health system and Health Care Partners, a very large physician-led organization serving a significant number of Emblem members. Jim led the expansion of those programs to additional Emblem members. Jim left EmblemHealth in August of 2017 to pursue an independent consulting career. He joined UR in late 2018 to lead the development of UR’s payer program offerings and was promoted to Chief Operating Officer in April 2020.

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