At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day. 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 Leverages reporting/data to monitor contract performance against financial, clinical, cost and efficiency targets 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 May serve as a mentor to team members assisting with onboarding and problem solving May be assigned to represent the business/function on special projects This is an individual contributor role
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Job Type
Full-time
Career Level
Manager
Number of Employees
5,001-10,000 employees