[Hiring] Senior Manager, Provider Performance Engagement Management @CVS Health

Role Description

This role will be accountable for the strategic alignment, operational success and performance management of assigned provider relationships, network and value-based relationships. Ensures that assigned value based contract arrangements are functioning successfully and working to improve quality of care while reducing costs.

• 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 reconciliations, etc.)
• Drives provider performance and partners with local market to ensure pathways to performance against business and team objectives.
• Drives improvement in deal performance for multiple lines of business.
• Leverages reporting/data to monitor contract performance against financial, clinical, cost and efficiency targets.
• Identifies and executes improvement opportunities.

Qualifications

• 7+ years experience in a health plan, health system or provider organization.
• 3+ years of Medicare experience.
• Proven ability to interact with, influence and collaborate with internal and external stakeholders at all levels.
• Experience managing matrixed environment with ability to leverage internal business partners to complete tasks.
• Knowledge of healthcare and insurance industry.
• Ability to form strong client relationships.
• Must reside in one of the following states: CO, KY, KS, IL, IA, IN, MI, MN, MO, ND, NE, OH, SD, WI.

Requirements

• ACO / managed-care experience preferred.
• Bachelor's degree or equivalent experience.

Benefits

• Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.