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. Position Summary 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.
Requirements
- 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
Nice To Haves
- ACO / managed-care experience preferred
Responsibilities
- 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.
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.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Number of Employees
5,001-10,000 employees
