AVP, Admission Prevention

Job not on LinkedIn

November 13

🌽 Illinois – Remote

Although this job is listed in Illinois, this company may be open to hiring remote in other states.

💵 $157.8k - $363.9k / year

⏰ Full Time

🔴 Lead

🎪 Events

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CVS Health

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Healthcare Insurance • Retail • Wellness

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

📋 Description

• Report to the Chief Clinical Officer and oversee the responsibility for overall admission prevention program • Lead a full strategic revamp and implement related change for Complex Patient Care, Transitions of Care and Emergency Department (ED) Diversion, Delegated Utilization Management / Care Management. • Provide strategic and operational leadership for Medical Management functions, including Transitions of Care, Complex Care, and Delegated UM/CM. • Create and drive integrated strategy across transitional care, complex care, and utilization management, ensuring functions work in concert to reduce avoidable admissions, improve patient outcomes, and manage total cost of care. • Oversee a cross-functional team and lead operations for centralized RN and MSWs cohorts and partner with field teams. • Drive transitional care programs aimed at preventing hospital readmissions and improving HEDIS stars performance. • Ensure optimal clinical outcomes and cost management for the highest-cost patients. • Develop and implement organization-wide strategies for care management and social determinants of health. • Collaborate with central clinical operations, population health, compliance, and finance teams to design and operationalize strategies that improve quality, cost, and patient experience. • Mentor and develop leaders within the Medical Management organization.

🎯 Requirements

• 15+ years of applicable experience in healthcare / population health / working with healthcare providers; or other similar fields. • Strong understanding of Value Based payment mechanisms. • Background in management consulting or equivalent strategic experience. • Strong leadership skills with the ability to inspire, build trust, and influence diverse stakeholders. • Strong business and financial acumen. • Must have strong financial and operational expertise with a history of achieving results. • Ability to operationalize external vendor solutions to complex operational issues. • Established ability to develop innovative operational changes. • Demonstrate executive presence and ability to interact with internal and external constituents. • Incredible level of organization and detail orientation. • Analytical and data savvy. • Ability to develop business cases, ROI analysis, and financial analysis. • Proven ability to connect the dots across teams and initiatives, proactively communicating how individual projects align with broader organizational goals. • Proficiency in Microsoft Office Suite, Google Workspace, and project management tools. • Demonstrates a pleasantly persistent approach to problem-solving and collaboration. • Brings a humble, team-oriented mindset to every interaction. • Quick to learn and thrive in environments with high levels of ambiguity and change.

🏖️ Benefits

• 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.