Senior Manager, Value Based Care Network Management - job 1 of 2

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary
Accountable for the strategic alignment, engagement, operational success and performance management of value based providers for all lines of business, complex Value Based Care models, and strategic provider partnerships, practices, or systems. Ensures that assigned value based contract arrangements are functioning successfully and working to improve quality of care while reducing costs. Successful candidates will be able to demonstrate adaptability and agility and who is comfortable with ambiguity and adapt to a dynamic environment.

Key Responsibilities: 

• Provider Relationship Management - Understands the terms of the value based contract arrangements to answer questions/address issues. Responsible for establishing and maintaining productive, professional relationships. 
• Educates internal and external parties as needed to ensure compliance with contract terms and expectations.
• Coordinates and prepares for external provider meetings and ensures that the most impactful internal subject matter experts (clinical, pharmacy, financial, analytical, etc.) are utilized to optimize performance. (External meetings include JOCs, clinical meetings, Informatics discussions, contract reconciliation, etc.).
• Drives provider performance and partners with local market to ensure pathways to performance against business and team objectives.
• Assists with workflow development and strategies to integrate data and reporting.
• Drives improvement in deal performance.
• Manage and negotiate annual Value Based Care Contract renewals and amendments
• Leverages reporting/data to monitor contract performance against financial, clinical, cost and efficiency targets.
• Identifies areas where improvements need to be made.
• Provides strategy consultation on actions/tactics to make those improvements. 

Required Qualifications

• 7+ years of experience in a health plan, health system or provider organization, ACO-Value Based Contracting / managed-care experience.
• Proven ability to interact with, influence and collaborate with  internal and external stakeholders which includes strategic alignment and collaboration with high-level executives
• Experience with California IPA and Capitation and an understanding as to how it impacts Value Based Care programs
• Experience managing matrixed environment with ability to leverage internal business partners to complete tasks.
• Good interpersonal and communication skills.
• 7+ years of healthcare and insurance industry.
• Ability to form strong client relationships.
• Understanding of Provider Contracting, Plan Design and Product Offerings. 

Preferred Qualifications

• Strong understanding of Value-Based Contracting Performance Management
• Preference for this person to reside in California
• Clinical background with experience managing Value Based Care Programs

Education

• Bachelor's degree or a combination of professional work experience and education.

Pay Range

The typical pay range for this role is:

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.  This position also includes an award target in the company’s equity award program. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.