Lead Director, Medicaid VBC Networks & Performance

4062 Aetna Resources, LLC; Illinois; Hybrid; USD 100,000 - 232,000; Full time

Benefits offered by this job

Bonus eligible

Equity awards

Comprehensive benefits

Job summary

CVS Health is seeking a leader to manage Medicaid value-based provider relationships and drive performance across complex networks in the Central Region. The role entails oversight of contracts, data analytics and steering cross-functional teams to reduce costs while maintaining high quality care.

You will supervise the VBS Provider Performance team, shape strategy with senior leaders, and ensure adherence to policies while promoting best practices across the network.

Qualifications

• 10 years experience in a health plan, health system or provider organization.
• Strong understanding of Medicaid products, provider engagement, and regulatory requirements.
• Experience directly managing people and/or teams.
• Excellent interpersonal and communication skills.

Responsibilities

• Manage provider relationships and ensure contract terms are met.
• Coordinate external provider meetings with clinical, pharmacy, financial, and analytical teams.
• Drive provider performance across multiple lines of business and complex models.
• Lead and supervise the VBS Provider Performance team and support strategic initiatives.

Skills

Medicaid knowledge

Provider engagement

Regulatory compliance

People management

Stakeholder collaboration

Data reporting

Education

Bachelor's degree preferred

Job description

CVS Health is seeking a leader to manage Medicaid value-based provider relationships and drive performance across complex networks in the Central Region. The role entails oversight of contracts, data analytics and steering cross-functional teams to reduce costs while maintaining high quality care.

You will supervise the VBS Provider Performance team, shape strategy with senior leaders, and ensure adherence to policies while promoting best practices across the network.