Senior Manager, Medicare/Medicaid Value-Based Partnerships

4062 Aetna Resources, LLC; Pennsylvania; Hybrid; USD 68,000 - 199,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Senior Manager, Value Based Contractor to collaborate with network leaders and business development to expand our Medicare and Medicaid VBC portfolio. You will help identify contracting opportunities, develop strategic provider relationships, and build financial models to support portfolio growth.

You will partner with Finance, Network and Segment teams to deploy VBC strategies, analyze market data, and drive ROI for enterprise scaling across health plans and providers.

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 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 grow.
• Educate leaders on specialty landscapes and financial models used.
• Partner with finance on development of financial models and VBC contracts.
• Collaborate with Network and Segment teams to deploy VBC strategies.
• Conduct market competitive analysis and design innovative value-based payment concepts.
• Work with cross-functional teams to create model solutions, pilots, and ROI for scaling.
• Serve as liaison among internal customers, operations, actuary, product, and analytics teams to ensure reimbursement initiatives meet needs.

Skills

Value-based care

Contracting

Provider relations

Cross-functional

Data interpretation

Education

Bachelor's degree

Job description

CVS Health is seeking a Senior Manager, Value Based Contractor to collaborate with network leaders and business development to expand our Medicare and Medicaid VBC portfolio. You will help identify contracting opportunities, develop strategic provider relationships, and build financial models to support portfolio growth.

You will partner with Finance, Network and Segment teams to deploy VBC strategies, analyze market data, and drive ROI for enterprise scaling across health plans and providers.