Senior Director, Medicaid Network & Provider Performance

CVS Health; Springfield (IL); On-site; USD 100,000 - 232,000; Full time

Job summary

CVS Health is seeking a senior leader to manage Medicaid value-based contracts and provider performance across central markets. You will align strategy, ensure regulatory compliance, and supervise the VBS Provider Performance team to improve value and reduce costs.

The role requires extensive industry knowledge, stakeholder collaboration, and a track record of driving large-scale performance improvements within health plans or provider networks.

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

Responsibilities

• Oversee strategic alignment and performance management of provider relationships.
• Lead Medicaid value-based care initiatives across the Central Region.
• Supervise VBS Provider Performance team members.
• Drive provider performance and monitor contract performance using data reporting.

Skills

Strong interpersonal and communication

People/Team management

Stakeholder collaboration

Healthcare knowledge

Education

Bachelor's degree

Job description

CVS Health is seeking a senior leader to manage Medicaid value-based contracts and provider performance across central markets. You will align strategy, ensure regulatory compliance, and supervise the VBS Provider Performance team to improve value and reduce costs.

The role requires extensive industry knowledge, stakeholder collaboration, and a track record of driving large-scale performance improvements within health plans or provider networks.