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Senior Provider Performance Manager

AT CVS Health
CVS Health

Senior Provider Performance Manager

Helena, MT

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary
Accountable for the strategic alignment, operational success and performance management of value based providers in one line of business, less complex Value Based Care models, and/or less sophisticated and smaller provider partnerships, practices, or systems. Ensures that assigned value based contract arrangements are functioning successfully and working to improve quality of care while reducing costs. Key Responsibilities:

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  • Provider Relationship Management - Understands the terms of the value based contract arrangements to answer questions/address issues. Responsible for establishing and maintaining productive, professional relationships .
  • Educates internal and external parties as needed to ensure compliance with contract terms and expectations.
  • Coordinates and prepares for external provider meetings and ensures that the most impactful internal subject matter experts (clinical, pharmacy, financial, analytical, etc.) are utilized to optimize performance. (External meetings include JOCs, clinical meetings, Informatics discussions, contract reconciliation , etc.).
  • Drives provider performance and partners with local market to ensure pathways to performance against business and team objectives.
  • Assists with workflow development and strategies to integrate data and reporting.
  • Drives improvement in deal performance.
  • Leverages reporting/data to monitor contract performance against financial, clinical, cost and efficiency targets.
  • Identifies areas where improvements need to be made.
  • Provides strategy consultation on actions/tactics to make those improvements.
Required Qualifications
  • 6+ years experience in a health plan, health system or provider organization, ACO-Value Based Contracting / managed-care experience preferred.
  • Proven ability to interact with, influence and collaborate with internal and external stakeholders.
  • Experience managing matrixed environment with ability to leverage internal business partners to complete tasks.
  • Good interpersonal and communication skills.
  • Knowledge of healthcare and insurance industry.
  • Ability to form strong client relationships.
  • Understanding of Provider Contracting, Plan Design and Product Offerings.
Preferred Qualifications
  • Strong understanding of Value-Based Contracting & Performance Management
Education
  • Bachelor's degree preferred or a combination of professional work experience and education.
Pay Range

The typical pay range for this role is:$67,900.00 - $182,549.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
  • Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
  • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 04/26/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Client-provided location(s): Helena, MT, USA
Job ID: CVS-R0551749_1005
Employment Type: Other

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • HSA
    • HSA With Employer Contribution
    • Pet Insurance
    • Mental Health Benefits
  • Parental Benefits

    • Fertility Benefits
    • Adoption Assistance Program
    • Family Support Resources
  • Work Flexibility

    • Flexible Work Hours
    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
  • Financial and Retirement

    • 401(K) With Company Matching
  • Professional Development

    • Tuition Reimbursement
  • Diversity and Inclusion

    • Employee Resource Groups (ERG)
    • Diversity, Equity, and Inclusion Program