Senior Director, Medicaid Network Performance

CVS Health; Kentucky; On-site; USD 100,000 - 232,000; Full time

Job summary

CVS Health is seeking a senior leader to manage strategic provider relationships and Medicaid value-based care initiatives across the Central Region. You will oversee performance, drive cost and quality improvements, and supervise the VBS Provider Performance team to deliver high-value outcomes.

The role emphasizes cross-functional collaboration, compliance with contract terms, and the ability to influence stakeholders at all levels while guiding performance strategies and operational execution.

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

• Provider Relationship Management – establish and maintain productive relationships.
• Educates internal and external parties to ensure compliance with contract terms.
• Coordinates for external provider meetings and uses internal experts to optimize performance.
• Assists with workflow development and data/reporting integration.
• Works independently to manage relationships and find solutions to problems.
• Drives provider performance and collaborates with local markets on performance objectives.
• Improves deal performance for multiple lines of business and complex models.
• Uses reporting to monitor contract performance against targets.
• Supervises VBS Provider Performance team members and identifies improvements.

Skills

Leadership

Stakeholder management

Contracting & negotiations

Regulatory compliance

Analytics & performance

Communication

Team supervision

Education

Bachelor's degree

Job description

CVS Health is seeking a senior leader to manage strategic provider relationships and Medicaid value-based care initiatives across the Central Region. You will oversee performance, drive cost and quality improvements, and supervise the VBS Provider Performance team to deliver high-value outcomes.

The role emphasizes cross-functional collaboration, compliance with contract terms, and the ability to influence stakeholders at all levels while guiding performance strategies and operational execution.