[Hiring] Manager, ACO Strategy & Operations @CVS Health

Role Description

As a Manager, ACO Strategy & Operations you will play a critical role in supporting our Oak Street Health patients, providers and business by serving as a critical leader in advancing Oak Street Health’s value-based care strategy. This role owns the operational, financial, and regulatory success of our ACO model, including ACO REACH, LEAD and MSSP. You will act as the primary bridge between clinical execution and strategic financial performance, ensuring that our clinical teams have the insights, workflows, and operational support necessary to maximize shared savings. You will approach federal government relationships with the mindset of a "business owner," building and nurturing vital connections with CMS and CMMI leadership teams. The ideal candidate is a self-directed, data-driven leader who brings innovative ideas and exceptional project management skills to a fast-paced environment.

Key Responsibilities

• ACO Operations & Strategy
  • Serve as the organizational leader for Oak Street Health's relationships with CMS and CMMI, overseeing contracting, contract implementation, operations, and ongoing management of the partnership.
  • Lead Government CMS and CMMI program implementations independently.
  • Project manage and own operational issues to resolution, while proactively developing and sharing ideas to improve Oak Street Health workflows.
  • Support delegated activities as required, including the identification of business requirements for system implementation and the oversight of vendor-driven activities.
• Financial & Quality Performance
  • Analyze the financial implications of existing and potential future CMS and CMMI value-based programs, quantifying and communicating organizational risk to senior leadership.
  • Proactively and professionally lead value-based contract negotiations, utilizing a strong understanding of key contract terms and their impact on Oak Street’s financial and operational performance.
  • Develop a deep understanding of operations and workflows across the organization, including financial, data, and clinical quality, and their key intersection points.
• Compliance & Reporting
  • Ensure strict, continuous compliance with all CMS regulations, program rules, and data submission requirements for MSSP, ACO REACH and/or LEAD.
  • Manage the annual quality reporting process, maintaining impeccable documentation and audit readiness across all participating TINs.
• Cross-Functional Leadership & Provider Engagement
  • Build and nurture strategic relationships with CMS and CMMI leadership teams.
  • Collaborate with other internal teams to drive strategic initiatives and resolve outstanding issues.
  • Lead conversations proactively and strategically with executives and field leadership regarding value-add activities and initiatives.

Qualifications

• Bachelor's degree.
• 5+ years of direct experience working in value-based care, with strong knowledge and past management of REACH and MSSP ACO programs.
• Expertise in CMS and CMMI value-based programs.
• Excellent communication, facilitation, and interpersonal skills with the ability to be personable yet persistent.
• Excellent problem-solving and analytical skills combined with impeccable business judgment.
• Ability to independently pursue and implement solutions to complex problems and manage multiple priorities in a fast-paced environment.
• Mastery of Microsoft Excel, Word, PowerPoint and Google Suite Programs.
• U.S. work authorization.
• Someone who embodies being “Oaky,” which includes radiating positive energy, assuming good intentions, creating an unmatched patient experience, driving clinical excellence, taking ownership and delivering results, and being relentlessly determined.

Preferred Qualifications

• Master’s degree in Healthcare Administration (MHA), Public Health (MPH), Business Administration (MBA), or a related field.
• Hands-on experience utilizing population health management platforms and advanced EMR integration.

Benefits

• A mission-focused career that impacts change and measurably improves health outcomes for Medicare patients.
• Paid vacation, sick time, and investment/retirement 401K match options.
• Health insurance, vision, and dental benefits.
• Opportunities for leadership development and continuing education stipends.
• New centers, flexible work environments, and opportunities for high levels of responsibility and rapid advancement.

Company Description

Oak Street Health is on a mission to “Rebuild healthcare as it should be'', providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest. Our innovative care model is centered right in our patient’s communities, and focused on the quality of care over volume of services. We’re an organization on the move! With over 150 locations and an ambitious growth trajectory, Oak Street Health is attracting and cultivating team members who embody “Oaky” values and passion for our mission.