[Hiring] Manager, Practice Transformation @CVS Health

Role Description

The Practice Transformation Advisor plays a critical role in supporting the highest standards of practice performance and quality within our organization's network of healthcare providers. The primary focus is to identify areas for quality improvement, partner with provider practices to implement quality strategies that improve quality and cost of care, member, and clinician experience, and drive positive outcomes in the delivery of patient care.

• Provider Engagement: Establish and maintain engagement with large provider groups that have a membership of 1,000 or greater.
• Performance Analysis: Conduct comprehensive analysis of provider performance metrics as well as clinical operations for VBC readiness and risk assessment. This includes clinical quality indicators, patient and provider satisfaction ratings, and operational efficiency measures. Identify areas of improvement and develop data-driven strategies to improve provider performance and financial rewards.
• Provider Education and Practice Transformation: Collaborate with cross-functional teams to assess practice operations against industry best practices in primary care. Design and deliver training programs, workshops, and educational materials for primary care and specialty providers and their staff in key operational domains to achieve improved health outcomes. Facilitate sessions on clinic operations, quality standards, regulatory compliance, member experience, and patient-centered care to enhance provider skills and knowledge.
• Performance Improvement Initiatives: Lead initiatives aimed at improving provider performance. Develop and implement performance improvement plans, monitor progress, and evaluate the effectiveness of interventions in collaboration with practice partners.
• Quality Assurance: Conduct regular audits, reviews, and assessments of provider practices, documentation, and compliance. Provide feedback and recommendations for improvement.
• Stakeholder Collaboration: Collaborate closely with internal teams, including clinical and operational leadership, value-based care, quality management teams, and provider relations teams to align provider performance objectives with organizational goals. Foster effective working relationships with providers, offering guidance, feedback, and support to facilitate their success.
• Data Management and Reporting: Utilize data management systems and analytics tools to collect, analyze, and report provider performance data. Prepare comprehensive reports, dashboards, and presentations for senior leadership, highlighting key performance indicators, trends, and improvement opportunities.
• Industry Knowledge and Research: Stay abreast of industry trends, best practices, and regulatory changes related to provider performance and healthcare quality. Support population health and health equity initiatives to improve care gap closure rates and health outcomes. Conduct research and benchmarking activities to identify innovative approaches and opportunities for improvement.

Qualifications

• 5-7 years of experience in healthcare quality improvement, provider relations, or a related role.
• In-depth knowledge of healthcare regulations, clinical operations, quality standards, and performance metrics.
• Strong analytical and problem-solving skills, with the ability to interpret complex data sets and identify improvement opportunities.
• Excellent communication, presentation, and interpersonal skills to collaborate with and effectively influence provider groups and executives, team members, and stakeholders at all levels.
• Proven experience in designing and delivering training programs or educational initiatives.
• Proficiency in data management and analysis tools, such as Excel or data visualization software.
• Familiarity with electronic health record systems and healthcare information technology.
• Detail-oriented, organized, and able to manage multiple projects simultaneously.
• Ability to work independently, demonstrate initiative, and drive results in a fast-paced environment.
• Position is remote – secure home network required and familiar with Microsoft Office products and VPN - with up to 30% regional travel.

Requirements

• Licensed Allied Health Professional or Licensed Registered Nurse.
• Coding or Provider facing, Clinical experience, or Provider Practice experience.
• Certified Six Sigma Green Belt.
• Certified Professional in Healthcare Quality (CPHQ) or equivalent.

Education/license requirements

• Bachelor's degree or commensurate work experience in healthcare administration, public health, or a related field.

Benefits

• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs.
• Other resources, based on eligibility.