Senior Manager, Medicare/Medicaid Value-Based Partnerships

CVS Health Corporation; Michigan; Hybrid; USD 68,000 - 199,000; Full time

Job summary

CVS Health Corporation is seeking a Senior Manager, Value Based Contractor to partner with Medicare and Medicaid leaders and advance strategic provider relationships as part of the National Value Based Solutions team.

You will identify contracting opportunities, develop financial models for VBC agreements, collaborate with network and segment teams to deploy strategies, and measure ROI while guiding cross-functional execution.

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

Responsibilities

• 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.

Skills

Value-based care contracting

Medicare/Medicaid contracting

Financial modeling

Risk-based arrangements

Provider relations

Execution/delivery

Cross-functional collaboration

Data interpretation

Education

Bachelor's degree

Job description

CVS Health Corporation is seeking a Senior Manager, Value Based Contractor to partner with Medicare and Medicaid leaders and advance strategic provider relationships as part of the National Value Based Solutions team.

You will identify contracting opportunities, develop financial models for VBC agreements, collaborate with network and segment teams to deploy strategies, and measure ROI while guiding cross-functional execution.