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Sr Mgr., Medicare Performance Management

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

This position is available throughout the United States. We are seeking a Senior Manager for the Medicare Performance Management Department to support the Lead Director and AVP. You will support via data pulling, data processing, conceptual model design, initiative planning, product management, performance management, and monitoring of member experience. You will be involved in the annual bid process and support high value initiatives of variable scale and complexity. These initiatives will impact the delivery of all Medicare products and services. In this role you will work with other business units across the Medicare segment on a variety of projects including, but not limited to, pulling and interpretating data, new process implementation, and ongoing operations of services, as well as troubleshooting complex issues.

Additionally, the Senior Manager will:

  • Identify opportunities for improvement, influence change through negotiation, consultation, and other actions that lead to improved performance.

  • Provide guidance and collaborate with external and internal partners in support of initiatives.

  • Support coaching and assist in the development of matrixed staff by providing direction, oversight, and feedback on work assignments.

  • May be responsible for concurrent initiatives as a team lead and/or team member, based on resource requirements.

Required Qualifications

  • Basic knowledge of Individual and Group Medicare.

  • Proficiency in Statistical Analysis System (SAS) and Structured Query Language (SQL) or similar programing experience.

  • 3 or more years of experience with Medicare, with an emphasis in Medicare operations, performance management, strategy, bid planning, and/or data analysis.

  • Strong business acumen.

  • Strong organizational/time management skills.

  • Effective communication skills with ability to clearly articulate information to a wide range of audiences, including senior leadership.

  • Excellent problem-solving capabilities, taking a proactive approach to identifying potential areas of improvement.

  • Proven experience working effectively on projects and initiatives with cross-functional teams involving a variety of stakeholders.

  • Quality review experience with a commitment to ensuring accuracy and compliance.

  • Ability to prioritize and handle multiple work tasks on an ongoing basis.

  • Positive presence with an ability to inspire others.

  • Collaboration and relationship management skills, with the capacity to quickly build and maintain credible relationships at varying levels of the organization.

  • Occasional travel may be required.

*This is an individual contributor role.


Preferred Qualifications

  • 5 or more years of experience with Medicare, with an emphasis in Medicare operations, performance management, strategy, bid planning, and/or data analysis.

  • Actuarial background

Education

Bachelor’s degree or equivalent work experience

Pay Range

The typical pay range for this role is:

$82,940.00 - $182,549.00


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

We anticipate the application window for this opening will close on: 04/25/2025

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

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Average salary estimate

$132744.5 / YEARLY (est.)
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$82940K
$182549K

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What You Should Know About Sr Mgr., Medicare Performance Management, CVS Health

At CVS Health, we’re on a mission to build a world of health that revolves around every consumer's needs, and we're looking for a dynamic Senior Manager in Medicare Performance Management to join our team in Hartford, CT! In this critical role, you will support the Lead Director and AVP by spearheading various initiatives that enhance the delivery of Medicare products and services across the nation. Your days will be filled with exciting tasks, from data analysis to conceptual model design, which will enable you to identify opportunities for operational improvements. You’ll collaborate with cross-functional teams to manage complex projects, participate in the annual bid process, and ensure member experiences are continuously optimized. With your basic knowledge of Medicare operations and experience in performance management, your insights will help shape our organizational strategies and improve our services. We value effective communication and strong problem-solving skills, so put those to use as you engage with both internal and external partners. If you're a proactive leader with a knack for data interpretation and a passion for transforming healthcare, CVS Health is the right place for you to make a real impact!

Frequently Asked Questions (FAQs) for Sr Mgr., Medicare Performance Management Role at CVS Health
What responsibilities does the Senior Manager, Medicare Performance Management have at CVS Health?

The Senior Manager, Medicare Performance Management at CVS Health is responsible for various critical functions including data pulling and processing, conceptual model design, and initiative planning. In this role, you will collaborate with cross-functional teams on a range of projects to enhance the delivery of Medicare products and services. Your involvement in annual bid processes and high-value initiatives will directly impact member experiences, making it essential to effectively communicate and manage relationships with internal and external partners.

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What qualifications are required for the Senior Manager position at CVS Health?

To qualify for the Senior Manager, Medicare Performance Management position at CVS Health, candidates should have at least a bachelor’s degree or equivalent work experience. A minimum of 3 years of experience in Medicare operations, performance management, strategy, bid planning, or data analysis is crucial. Proficiency in statistical software like SAS and SQL is preferred, along with demonstrated leadership capability to inspire and mentor teams effectively.

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What does a typical day look like for a Senior Manager in Medicare Performance Management at CVS Health?

A typical day for the Senior Manager, Medicare Performance Management at CVS Health involves a blend of analytical work and strategic planning. You will often pull and interpret data, oversee the implementation of new processes, and manage ongoing operations of services. The role also includes conducting quality reviews, leading concurrent initiatives, and collaborating with colleagues to drive performance improvements, all while maintaining an inspiring presence in the team.

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How does the Senior Manager role contribute to CVS Health's mission?

The Senior Manager, Medicare Performance Management position is pivotal in supporting CVS Health's mission of transforming healthcare delivery. By effectively analyzing data and leading various initiatives, this role ensures that Medicare products and services are not only compliant but also delivered with heart to positively impact member experiences. Consequently, your contributions help in fostering a healthier community and enhancing the lives of millions across the nation.

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What benefits does CVS Health offer to the Senior Manager, Medicare Performance Management?

CVS Health offers a competitive benefits package for the Senior Manager, Medicare Performance Management, including affordable medical plan options, a 401(k) with company matching, and employee stock purchasing programs. Additional perks include wellness screenings, tobacco cessation programs, financial coaching, and various paid time off options. The company’s commitment to well-being and professional development enhances the work-life balance critical for success in this role.

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Common Interview Questions for Sr Mgr., Medicare Performance Management
What inspired you to pursue the Senior Manager position in Medicare Performance Management?

In my pursuit of the Senior Manager role in Medicare Performance Management, I am drawn to CVS Health's commitment to transforming healthcare. I believe that my background in data analysis and passion for improving member experiences aligns perfectly with this mission.

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Can you describe your experience with data analysis in a Medicare context?

Certainly! In my previous positions, I have utilized statistical tools like SAS and SQL to analyze data related to Medicare performance management, which allowed me to identify operational efficiencies and improve overall service delivery.

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How do you handle complex projects involving multiple stakeholders?

Handling complex projects requires effective communication and meticulous organization. I prioritize tasks, define clear roles for stakeholders, and ensure regular updates to maintain alignment and collaboration throughout the project lifecycle.

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What strategies do you use to identify areas for performance improvement?

I employ a data-driven approach to performance improvement. By analyzing key metrics and conducting quality reviews, I can pinpoint specific areas needing enhancement and propose actionable strategies to address those gaps.

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Describe a time you influenced a change in a team or organization. How did you do it?

Recently, I led a project that required changing an established process. I gathered data to illustrate the benefits of the proposed changes, consulted with team members for their input, and used negotiation skills to gain buy-in, ultimately resulting in improved efficiency.

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What methods do you use to support your team in achieving their goals?

I prioritize open communication and regular check-ins to support my team effectively. Providing constructive feedback and recognizing achievements helps foster a positive work environment that encourages collaboration and growth.

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How do you ensure compliance and accuracy in your work?

Ensuring compliance and accuracy is paramount. I implement rigorous quality checks at every stage of the process and stay updated on compliance regulations, providing training to my team to minimize errors and maintain standards.

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What is your approach to mentoring less experienced colleagues?

My approach to mentoring includes personalized guidance based on individual strengths and areas for growth. I foster an inclusive learning environment where juniors feel comfortable asking questions and exploring new ideas.

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How do you manage your time and prioritize tasks effectively?

I utilize a combination of project management tools and prioritization frameworks to manage my time effectively. By breaking projects into manageable tasks and setting clear deadlines, I can focus on what is most important without getting overwhelmed.

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What role do you think collaboration plays in success within Medicare Performance Management?

Collaboration is essential in Medicare Performance Management, as it combines diverse perspectives and expertise to solve complex challenges. By fostering a collaborative environment, we enhance innovation and ultimately improve our service delivery.

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We help people with their health wherever and whenever they need us. And we do it with heart. Because our passion is our purpose: Bringing our heart to every moment of your health™.

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DATE POSTED
April 21, 2025

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