About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary This position is accountable for the strategic alignment, operational success and performance management of Medicare Advantage Value-Based Contracts (VBC), by ensuring that VBC arrangements function successfully and work to improve quality of care while reducing costs. This role will serve as the analytics partner for VBC contracts, working with both internal and external partners, to provide medical cost and outcomes focused analytical research, financial modeling, and business decision support. Understand the terms of the VBC arrangements to answer questions, address issues, and provide analytical support Responsible for establishing and maintaining productive, professional relationships with the most complex/high value initiatives and/or highest risk and revenue generating provider systems, networks and value-based relationships Sets the tone for the VBC relationships for both internal and external partners Educates internal and external parties as needed to ensure compliance with contract terms and expectations Assists with workflow development and strategies to integrate data and reporting Works independently to manage relationships and identify/implement solutions to problems Drives provider performance and partners with local market to ensure pathways to performance against business and team objectives Able to perform complex financial assessments Identifies areas where improvements need to be made Advocates-for and drives strategy consultation on actions/tactics to make those improvements Able to advise/counsel network partners on value-based negotiations, deal terms and best practices This is an individual contributor role

Requirements

  • The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment.
  • Bachelor’s degree along with 3+ years related experience
  • Prior Healthcare experience
  • Experience with Microsoft Office suite, especially Excel
  • Experience with SQL, working with large and detailed data sets
  • Strong communication skills
  • Strong analytic and time management skills
  • Demonstrates success in collaborating with others to meet/exceed expectations

Nice To Haves

  • Experience in Medicare Advantage and/or Value Based Contracting
  • Ability to remain flexible with ever changing priorities
  • Strong collaboration and organization skills working across various teams
  • Ability to communicate effectively with all levels

Responsibilities

  • strategic alignment
  • operational success
  • performance management of Medicare Advantage Value-Based Contracts (VBC)
  • VBC arrangements function successfully and work to improve quality of care while reducing costs
  • analytics partner for VBC contracts
  • provide medical cost and outcomes focused analytical research, financial modeling, and business decision support
  • Understand the terms of the VBC arrangements to answer questions, address issues, and provide analytical support
  • establishing and maintaining productive, professional relationships with the most complex/high value initiatives and/or highest risk and revenue generating provider systems, networks and value-based relationships
  • Sets the tone for the VBC relationships for both internal and external partners
  • Educates internal and external parties as needed to ensure compliance with contract terms and expectations
  • Assists with workflow development and strategies to integrate data and reporting
  • Works independently to manage relationships and identify/implement solutions to problems
  • Drives provider performance and partners with local market to ensure pathways to performance against business and team objectives
  • Able to perform complex financial assessments
  • Identifies areas where improvements need to be made
  • Advocates-for and drives strategy consultation on actions/tactics to make those improvements
  • Able to advise/counsel network partners on value-based negotiations, deal terms and best practices

Benefits

  • 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.
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