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Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.Position Summary
Aetna is seeking to hire a Vice President, Value-Based Contracts Analytics. The VP, Value Based Contracts Analytics will lead end to end evaluation of value-based contracts pipeline to optimize strategic partnerships and performance.Major Responsibilities:
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- Align with value based contracting (VBC Analytics) strategy for all lines of business (Medicare, Medicaid, IFP, Commercial, Specialty), including model development and execution
- Engage and collaborate with Aetna business partners and senior leadership to ensure optimal financial performance of all VBC Analytics deals
- Develop strategic framework for deal prioritization and implementation; align/influence all support functions to reflect that strategy, both within and outside areas of authority
- Evaluate pipeline to optimize deals and market performance; provide innovative solutions in order to drive optimal decisions and outcomes
- Provide end to end support of all contract deals, from pre-deal modeling to assessment of return on investment to reviewing key contractual financial terms
- Facilitate data-driven decision-making through the design and development of data models, dashboards, and reports to track performance of value-based contracts
- Facilitate the streamlined delivery of reports, data, and other information to provider groups
- Ensure strategic technical solutions are in place to administer and analyze value-based deals and performance
- Ensure proper financial controls are in place across all value based analytics processes, along with secure, consistent, compliant and financially sound reporting
- Provide Senior leaders with monthly view of value based contracting accruals, key judgements and insights into receivable balances
- Provide thought leadership to create strategic partnerships with providers. Consult with external provider partners to drive optimal quality and efficiency results, as well as better outcomes for our members.
- Oversee capitation and fee schedule analytics; develop and propose innovative payment methodologies for physicians, including next generation bundling logic and management and national and local capitation contract structure.
- Lead team to ensure accuracy and efficiency of accruals and reconciliation management process as well as SAIs, pModel trends, audit support, and VBC administration review and approval.
- Foster technological innovation, leveraging emerging analytics technologies to drive novel insights and enable more sophisticated means of data-based decision-making
- Ensure that all analytics and models comply with applicable healthcare regulations, payer guidelines, and reporting requirements
- Drive high talent performance and foster a culture of innovation, collaboration and continuous improvement
- 15+ years medical economics, actuarial, data science, business intelligence and/or data analysis experience within managed care industry
- Deep knowledge of risk-based/value-based provider arrangements and value-based benefits
- Strong understanding of healthcare data models and financial, statistical and analytical reporting (eg SAS, R, SSMS, BigQuery, SQL, Python, Tableau, Alteryx, etc)
- Strong analytical thinking with the ability to translate complex data into actionable insights
- Strong financial acumen
- Background in financial operational processes
- Demonstrated leadership capabilities with a strong focus on mentorship and development of analytical talent
- Exceptional interpersonal and communication skills
- Proven ability to interact with, collaborate with, and influence internal and external stakeholders at all levels
- Open to remote in New England region
- Travel as needed per business demands
Bachelors degree with preference in analytical fieldThe typical pay range for this role is:
$220,000-$320,000This 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.In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefitsWe anticipate the application window for this opening will close on: 03/24/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through ColleagueRelations@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.