Senior Director, Medicaid Value-Based Network Strategy

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

Benefits offered by this job

Bonus program

Equity award

Benefits package

Job summary

CVS Health is seeking a senior leader to oversee Medicaid value-based contracting and provider performance across the Central Region, aligning strategy, driving performance, and supervising the VBS Provider Performance team to improve quality of care while reducing costs.

You will collaborate with clinical, pharmacy, financial and analytical partners, manage complex provider relationships, and influence stakeholders to achieve organizational goals.

Qualifications

• 10 years experience in a health plan, health system or provider organization.
• Strong Medicaid knowledge and regulatory compliance requirements.
• Experience directly managing people and/or Teams
• Self-directed with independent problem-solving skills
• Ability to interact with and influence stakeholders at all levels
• Experience in a matrixed environment with internal partners

Responsibilities

• Manage provider relationships and ensure contract terms are followed.
• Educate internal/external parties to ensure contract compliance.
• Coordinate external provider meetings with clinical, pharmacy and analytic experts.
• Assist with workflows to integrate data and reporting.
• Work independently to manage relationships and resolve issues.
• Drive provider performance and collaborate with local markets.
• Monitor contract performance against financial and clinical targets.
• Provide strategy guidance to improve deal performance and oversee team.

Skills

Provider relationships

Contracting knowledge

Regulatory compliance

Team leadership

Stakeholder management

Healthcare knowledge

Education

Bachelor's degree preferred

Job description

CVS Health is seeking a senior leader to oversee Medicaid value-based contracting and provider performance across the Central Region, aligning strategy, driving performance, and supervising the VBS Provider Performance team to improve quality of care while reducing costs.

You will collaborate with clinical, pharmacy, financial and analytical partners, manage complex provider relationships, and influence stakeholders to achieve organizational goals.