Senior Manager, National Specialty Value Based Care Provider Performance

CVS Health

1d

About The Position

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. Implements Vale Based Care (VBC) National Specialty network strategies, monitors provider performance metrics, leads dispute resolution processes, and collaborates with key stakeholders to drive network growth and ensure high-quality provider relationships. What you will do Develops and implements internal and external strategies to effectively assess and advance the performance of healthcare providers within the company's network. Develops and maintains provider scorecards and performance reports to track and communicate performance metrics to internal stakeholders, executives, and network providers. Monitors and evaluates provider performance metrics, such as quality indicators, patient satisfaction scores, cost efficiency measures, and adherence to clinical guidelines. Communicates with providers to develop and implement initiatives aimed at enhancing quality of care, patient outcomes, and operational efficiency. Contributes to business objectives by collaborating with the network development team to identify providers that align with the company's strategic goals and objectives. Manages operational aspects of the team, and implements workforce and succession plans to successfully achieve business goals. Guides management for individual performance evaluations aimed to provide critical feedback for skills development and depth of work area experience.

Requirements

• A minimum of 5 years related experience with provider engagement, relations, or account management.
• Working knowledge of Medicare contracts.
• An understanding of value based contracts, how they work, what is the value.
• Strong presentation skills, the ability to communicate effectively.
• Mastery of problem solving and decision making skills
• Strong MS Office skills.

Nice To Haves

• The ability to use data to tell a story.
• Mastery of growth mindset (agility and developing yourself and others) skills.

Responsibilities

• Develops and implements internal and external strategies to effectively assess and advance the performance of healthcare providers within the company's network.
• Develops and maintains provider scorecards and performance reports to track and communicate performance metrics to internal stakeholders, executives, and network providers.
• Monitors and evaluates provider performance metrics, such as quality indicators, patient satisfaction scores, cost efficiency measures, and adherence to clinical guidelines.
• Communicates with providers to develop and implement initiatives aimed at enhancing quality of care, patient outcomes, and operational efficiency.
• Contributes to business objectives by collaborating with the network development team to identify providers that align with the company's strategic goals and objectives.
• Manages operational aspects of the team, and implements workforce and succession plans to successfully achieve business goals.
• Guides management for individual performance evaluations aimed to provide critical feedback for skills development and depth of work area experience.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees