Lead Director, Business Performance – Medicaid

Job not on LinkedIn

🔥 7 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $100k - $231.5k / year

⏰ Full Time

🟠 Senior

👔 Director

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

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.

📋 Description

• Lead development, implementation, and oversight of reporting solutions supporting strategic Medicaid programs and state-directed initiatives • Translate complex business objectives into actionable analytics, dashboards, and executive reporting • Identify opportunities to improve program performance through data-driven insights and operational recommendations • Advise executive leadership on program outcomes, emerging risks, and performance trends • Establish governance and reporting structures for state-sponsored Medicaid initiatives, financial performance and ROI, provider partnerships, community-based organization engagement, and vendor performance • Develop executive-level scorecards, KPIs, dashboards, and performance monitoring frameworks • Analyze claims, encounter, utilization, quality, and financial data • Partner with provider organizations, value-based care partners, and community-based organizations to evaluate effectiveness and outcomes • Support innovative partnerships addressing health-related social needs • Monitor partnership performance and recommend corrective actions or expansion opportunities • Establish vendor cohorts and performance segmentation strategies • Develop methodologies evaluating vendors against operational, financial, quality, and member outcome metrics • Drive accountability through performance reviews and improvement plans • Lead, mentor, and develop Senior Managers and business consultants • Build relationships with executives and senior leaders across matrixed organizations • Present results, insights, recommendations, and strategic analyses to senior leadership • Navigate complex organizational structures and lead large-scale cross-functional initiatives • Align program goals with corporate objectives, state requirements, and member needs

🎯 Requirements

• 8+ years of progressive leadership experience in healthcare, managed care, consulting, analytics, or business strategy • 5+ years leading high-performing teams and people leaders • Significant experience within Medicaid managed care organizations, state Medicaid programs, or healthcare consulting environments • Demonstrated experience working with healthcare claims and encounter data to drive strategic decision-making • Experience developing executive-level reporting and performance management frameworks • Proven success managing cross-functional initiatives involving multiple stakeholders and business units • Bachelor's degree or equivalent work experience • Preferred: experience supporting state Medicaid contracts, quality improvement initiatives, or value-based care programs • Preferred: experience working with provider organizations, community-based organizations, and external vendors • Preferred: knowledge of social determinants of health and community partnership strategies • Preferred: experience with vendor oversight and outcome-based performance measurement • Preferred: familiarity with Medicaid quality measures, regulatory requirements, and healthcare reimbursement methodologies • Preferred: experience in a highly matrixed healthcare organization

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program • Equity award program • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being