Senior Manager, Provider Network Strategy (Louisiana)

CVS Health•Work At Home-Louisiana, LA

3d•$67,900 - $149,328•Onsite

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. The Senior Manager, Network Management, serves a critical role in advancing Provider Network strategy for the Louisiana Medicaid Market. This position is essential to monitor and manage our proactive network strategy ensuring compliance with LDH and NCQA standards while optimizing cost-effective care delivery and access to care for our members.

Requirements

7+ years of experience in Medicaid managed care provider contracting, provider engagement, performance management, or value-based contracting.
Strong understanding of Medicaid provider environment and reimbursement models.
Experience with internal / external stakeholder engagement and partnership.
Must live in the Louisiana market

Nice To Haves

Knowledge of Louisiana Medicaid landscape
Solution-driven approach to provider challenges
Change-enablement strategies and execution experience
Adept at business intelligence.

Responsibilities

Support NCQA accreditation and compliance with Louisiana Dept. of Health (LDH) network standards by monitoring monthly progress towards annual network development plan objectives and providing alternative strategies to achieve at-risk goals.
Conducts market analysis, assesses competitive positioning, and recommends strategies to identify opportunities for market growth and provider partnerships.
Build internal pipeline of provider recruiting targets by priority and create departmental training materials on identifying appropriate targets in response to various LDH and market initiatives.
Design NM activity dashboard to promote leadership visibility into contracting productivity, project status, and escalation requests.
Develop and deploy engagement and change strategies that accelerate adoption of new processes, tools, and operational practices.
Provide real-time recommendations to senior leadership to guide decision-making and ensure close alignment with the organization's strategic goals and objectives.
Partner with matrixed leaders to diagnose organizational challenges and identify solutions that improve clarity, effectiveness, and outcomes.