Senior Manager, Value-Based Contracting (Medicare/Medicaid)

CVS Health Corporation; Harrisburg (Dauphin County); Remote; USD 68,000 - 199,000; Full time

Job summary

CVS Health Corporation is seeking a Senior Manager, Value Based Contracting, to lead Medicare and Medicaid value-based contracting initiatives and partner with business development, network leaders, and clinical teams to scale innovative provider arrangements.

You will collaborate across networks and analytics to design contracts, model financial outcomes, and drive ROI for enterprise-wide adoption.

Qualifications

• 7+ years of experience in value-based care contracting and provider relations.
• Medicaid or Medicare contracting experience, ideally with large specialty groups.
• Experience in value-based care financial modeling.
• Experience in risk-based arrangements in government services.
• Strong execution, planning and delivery skills.
• Excellent organizational skills in a matrixed environment.
• Ability to translate complex data into clear insights.

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 strategies for growth.
• Develop and educate leaders on specialty landscapes and financial models used across the industry.
• Partner with finance on the development of financial models and VBC contracts to support portfolio growth.
• Work with Network and Segment teams to deploy VBC strategies in a timely manner.
• Perform market analysis and engage contracting and clinical teams to create innovative value-based payment concepts.
• Collaborate with cross-functional teams to create model solutions, pilots, and ROI for scaling.
• Serve as a liaison among internal customers, operations, actuary, product, and analytics teams to meet needs.

Skills

Value-based contracting

Medicare/Medicaid contracting

VBC financial models

Risk-based arrangements

Execution & delivery

Organizational skills

Data presentation

Education

Bachelor’s degree

Job description

CVS Health Corporation is seeking a Senior Manager, Value Based Contracting, to lead Medicare and Medicaid value-based contracting initiatives and partner with business development, network leaders, and clinical teams to scale innovative provider arrangements.

You will collaborate across networks and analytics to design contracts, model financial outcomes, and drive ROI for enterprise-wide adoption.