Senior Manager, National Value-Based Care Partnerships

CVS Health Corporation; New York (NY); Hybrid; USD 68,000 - 199,000; Full time

Benefits offered by this job

Comprehensive benefits

Bonus eligibility

Job summary

CVS Health is seeking a Senior Manager, Value Based Contractor to pioneer contracting with Medicare and Medicaid provider partners. The role collaborates across network and clinical teams to accelerate market speed, growth of the Specialty and Medicaid VBC portfolio, and alignment with enterprise goals.

The ideal candidate has 7+ years in value-based care contracting, strong financial modeling skills, and a proven ability to execute in a matrixed environment.

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.

Responsibilities

• Support the process for identifying, evaluating, and completing contracting with Specialty and Medicaid provider partners.
• Develop 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.
• Partner with finance on the development of financial models and VBC contracts to support portfolio growth.
• Partner 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

Provider relations

Medicare/Medicaid contracting

Financial modeling

Risk-based arrangements

Data interpretation

Cross-functional collaboration

Execution and delivery

Education

Bachelor's degree

Job description

CVS Health is seeking a Senior Manager, Value Based Contractor to pioneer contracting with Medicare and Medicaid provider partners. The role collaborates across network and clinical teams to accelerate market speed, growth of the Specialty and Medicaid VBC portfolio, and alignment with enterprise goals.

The ideal candidate has 7+ years in value-based care contracting, strong financial modeling skills, and a proven ability to execute in a matrixed environment.