Lead Director, Provider Performance-Georgia and Gulf States, Remote

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
This position will support primarily Georgia and the Gulf States markets, given the current VBC footprint and overall complexity of operations in these areas. Role will support VBC contracting efforts, stronger payer-provider relationships and improved financial performance.

This position is accountable for the strategic alignment, operational success, and performance management of assigned provider relationships with the most complex/high value initiatives and/or highest risk and revenue generating provider systems, network and value-based relationships. Ensures that assigned value-based contract arrangements are functioning successfully and working to improve quality of care while reducing costs.

**The position is remote and can be in any US location, preference will be given to candidates that reside in Georgia.

Key Responsibilities:

• 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 reconciliations, etc.)

• Assists with workflow development and strategies to integrate data and reporting.

• Works independently to manage relationships and identify/implement solutions to problems.

• Drives provider performance and partners with local market to ensure pathways to performance against business and team objectives.

• Drives improvement in deal performance for multiple lines of business, complex models, and/or advanced national provider partners.

• Leverages reporting/data to monitor contract performance against financial, clinical, cost and efficiency targets. Adept at identifying issues or trends in reporting.

• Identifies improvement opportunities. Provides strategy consultation on actions/tactics to make needed improvements.

Required Qualifications

• Minimum 10+ years of experience in network relations, VBC arrangements, and performance management in a health plan, health system or provider organization, ACO / managed-care experience preferred

• Proven expertise in contract language and interpretation, financial modeling, and/or risk-based arrangements.

• Strong analytical skills with the ability to assess provider performance and financial impact.

• Self-directed individual with independent problem-solving skills

• Proven ability to interact with, influence and collaborate with internal and external stakeholders at all levels

• 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

Education

• Bachelor's degree preferred in business administration, HealthCare Administration, or a related field or equivalent work experience.

Pay Range

The typical pay range for this role is:

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 people

We 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.

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Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.