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Sr. Manager Provider Performance
Sr. Manager Provider Performance-November 2024
Hartford
Nov 14, 2024
ABOUT CVS HEALTH
CVS Health is a healthcare innovation company. Together, we are helping people on their path to better health.
10,000+ employees
Healthcare
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About Sr. Manager Provider Performance

  Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

  Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

  Position Summary

  The Senior manager is accountable for the strategic alignment, operational success and performance management.

  Assigned to VBS Providers limited to only one line of business (Medicare or Commercial) and/or less complex VBS models (Medicare Lites, Commercial P4Ps) and less sophisticated and smaller provider partnerships (small Physician practices, small-medium sized health systems).

  Ensures that assigned VBC arrangements are functioning successfully and working to improve quality of care while reducing costs.

  Primary Job Duties & Responsibilities:

  VBS Provider Relationship Management - Understands the terms of the VBC arrangements to answer questions/address issues. Responsible for establishing and maintaining a productive, professional relationships

  Sets the tone for the relationship

  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 in order to optimize performance. (External meetings include JOCs, clinical meetings, Informatics discussions, contract reconciliations, etc.)

  Deal Performance Management

  Responsible for driving improvement in deal performance

  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

  3-5 years VBC payment methodologies (alternate payment models).

  Knowledge of healthcare and insurance industry

  Experience managing matrixed environment with ability to leverage internal business partners to complete tasks

  Understanding of Provider Contracting, Plan Design and Product Offerings

  Ability to travel in assigned territory as needed

  Preferred Qualifications

  Bachelor's Degree Preferred

  5+ years experience in a health plan, health system or provider organization, ACO / managed-care experience preferred

  Good interpersonal and communication skills

  Ability to form strong client relationships.

  Proven ability to interact with, influence and collaborate with internal and external stakeholders

  Preferred location: New England region

  Education

  Bachelor's Degree or equivalent work experience.

  Pay Range

  The typical pay range for this role is:

  $79,200.00 - $170,800.00

  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.

  In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

  For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

  CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

  You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

  CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [email protected] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.

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