Senior Manager, Provider Contracting – National Specialty Value Based Care Partnerships

Job not on LinkedIn

6 days ago

🌵 Arizona – Remote

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

🏈 Ohio – Remote

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

+2 more states

🌵 Arizona – Remote 🏈 Ohio – Remote 🔔 Pennsylvania – Remote 🤠 Texas – Remote

💵 $67.9k - $199.1k / year

⏰ Full Time

🟠 Senior

💰 Account Manager

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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

• Supporting the process for identifying, evaluating, and completing contracting with Specialty and Medicaid provider partners. • Developing relationships with leaders of specialty chronic kidney, oncology, polychronic/complex care, and emerging specialty types) or Medicaid provider organizations to design and execute on strategies for growth. • Develop and educate leaders on specialty landscapes and what financial models are being used across the industry. • Partnering with finance on the development of financial models and VBC contracts to support portfolio growth. • Partnering with Network and Segment teams to ensure deployment of VBC strategies are executed timely. • Perform market competitive analysis, engage contracting and clinical teams to create innovative value-based payment concepts. • Work with cross functional teams to create and initiate model solution development, pilot models, and ensure initial ROI for enterprise scaling. • Serve as a liaison among internal customers, operations, actuary, product, and analytic teams to ensure reimbursement initiatives meet the needs of internal and external customers.

🎯 Requirements

• 5+ years of experience in value-based care in contracting, provider relations, provider operations and/or solutions • Experience in Value Based Care financial models • Experience in Risk-based arrangements and Value-Based care in government services • Adept at execution and delivery (planning, delivering, and supporting) skills • Strong organization and detail skills working in a highly matrixed environment • Ability to present and translate complex data into digestible information

🏖️ Benefits

• Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs • Confidential counseling and financial coaching • 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