Provider Contracting Senior Manager, National Specialty Value Based Care Partnerships...

Colorado Psychiatric; Denver (CO); Hybrid; USD 68,000 - 199,000; Full time

Benefits offered by this job

Comprehensive benefits package

Bonus eligibility

Equity awards

Job summary

CVS Health is recruiting for a Senior Manager, Value Based Contractor, supporting Medicare and Medicaid and partnering with business development and network leaders to build innovative provider relationships as part of the National Value Based Solutions Specialty Partnership team.

You will collaborate across the Network and Clinical organizations to ensure speed to market and support segment leaders with growing our Specialty and Medicaid VBC portfolio.

Qualifications

• 7+ years of experience in value-based care contracting, provider relations, provider operations and/or solutions.
• Medicaid or Medicare contracting experience required, working with large specialty groups preferred.
• Experience in Value Based Care financial models.
• Experience in Risk-based arrangements and Value-Based care in government services.
• Adept at execution and delivery (planning, delivering, and supporting) skills.
• Strong organization and detail skills in a highly matrixed environment.
• Ability to present and translate complex data into digestible information.

Responsibilities

• Identify, evaluate, and complete contracting with specialty and Medicaid provider partners.
• Develop relationships with leaders of specialty or Medicaid provider organizations to design and execute on strategies for growth.
• Develop and educate leaders on specialty landscapes and what financial models are being used across the industry.
• Partner with finance on the development of financial models and VBC contracts to support portfolio growth.
• Partner with Network and Segment teams to ensure deployment of VBC strategies are executed timely.
• Perform market competitive analysis, engage contracting and clinical teams to create innovative value-based payment concepts.
• Work with cross functional teams to create and initiate model solution development, pilot models, and ensure initial ROI for enterprise scaling.
• Serve as a liaison among internal customers, operations, actuary, product, and analytic teams to ensure reimbursement initiatives meet the needs of internal and external customers.

Skills

Value-based contracting

Provider relations

Contracting operations

Financial modeling

Cross-functional collab

Risk-based models

Education

Bachelor's degree

Job description

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.

Position Summary

Aetna is recruiting for a Senior Manager; Value Based Contractor supporting Medicare and Medicaid and will partner with business development and network leaders to build innovative and strategic provider relationships as part of the National Value Based Solutions Specialty Partnership team. You will work collaboratively across the Network and Clinical organizations to ensure speed in market and to support segment leaders with growing our Specialty and Medicaid VBC portfolio.

You will make an impact by:

• Supporting the process for identifying, evaluating, and completing contracting with Specialty and Medicaid provider partners.
• Developing relationships with leaders of specialty or Medicaid provider organizations to design and execute on strategies for growth.
• Develop and educate leaders on specialty landscapes and what financial models are being used across the industry.
• Partnering with finance on the development of financial models and VBC contracts to support portfolio growth.
• Partnering with Network and Segment teams to ensure deployment of VBC strategies are executed timely.
• Perform market competitive analysis, engage contracting and clinical teams to create innovative value-based payment concepts.
• Work with cross functional teams to create and initiate model solution development, pilot models, and ensure initial ROI for enterprise scaling.
• Serve as a liaison among internal customers, operations, actuary, product, and analytic teams to ensure reimbursement initiatives meet the needs of internal and external customers.

Required Qualifications

• 7+ years of experience in value-based care contracting, provider relations, provider operations and/or solutions.
• Medicaid or Medicare contracting experience required, working with large specialty groups preferred
• Experience in Value Based Care financial models.
• Experience in Risk-based arrangements and Value-Based care in government services
• Adept at execution and delivery (planning, delivering, and supporting) skills.
• Strong organization and detail skills working in a highly matrixed environment.
• Ability to present and translate complex data into digestible information.

Education Requirements

• Bachelor's degree preferred/specialized training/relevant professional qualification.

Pay Range

The typical pay range for this role is:

$67,900.00 - $199,144.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 10/30/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.