Lead Director, Medicaid Network & VBC Strategy

CVS Health; Michigan; Hybrid; USD 100,000 - 232,000; Full time

Benefits offered by this job

Comprehensive benefits

Equity award program

Bonus eligibility

Job summary

CVS Health is hiring for a role focused on strategic alignment and performance management of Medicaid value-based contracts with complex provider systems. The position leads VBC initiatives regionally and supervises the VBS Provider Performance team, driving contract performance and cost quality improvements.

Responsibilities include engaging internal and external stakeholders, improving data integration, and guiding improvement initiatives while aligning with organizational goals and compliance

Qualifications

• 10 years experience in a health plan, health system or provider organization, ACO / managed-care experience preferred.
• Strong understanding of Medicaid products, provider engagement, and regulatory compliance requirements.
• Experience directly managing people and/or Teams.
• Self-directed individual with independent problem-solving skills.
• 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.
• Good interpersonal and communication skills.
• Knowledge of healthcare and insurance industry.
• Ability to form strong client relationships.

Responsibilities

• Provide strategic alignment, operational success and performance management for value-based provider relationships.
• Lead Medicaid value-based care initiatives across the Central Region.
• Educate internal and external parties to ensure contract compliance.
• Coordinate external provider meetings and involve key internal experts to optimize performance.
• Develop workflows for data integration and reporting.
• Supervise VBS Provider Performance team members and provide strategic guidance.

Skills

Health plan experience

Medicaid knowledge

People management

Regulatory compliance

Stakeholder management

Matrixed environment

Interpersonal skills

Healthcare industry knowledge

Client relationship building

Education

Bachelor's degree

Job description

CVS Health is hiring for a role focused on strategic alignment and performance management of Medicaid value-based contracts with complex provider systems. The position leads VBC initiatives regionally and supervises the VBS Provider Performance team, driving contract performance and cost quality improvements.

Responsibilities include engaging internal and external stakeholders, improving data integration, and guiding improvement initiatives while aligning with organizational goals and compliance