Lead Director, Provider Performance Value-Based Care

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🔥 0 minutes ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

💵 $100k - $231.5k / year

⏰ Full Time

🟠 Senior

👔 Director

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

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.

📋 Description

• establish and maintain productive value-based relationships with key network providers • develop and manage the Keystone Value-based Network • negotiate high value/risk contracts with complex arrangement structures • manage complete value-based contracting cycle • work with internal teams to develop a value-based strategic plan • oversee contract performance with targeted provider groups • evaluate and implement network strategic plans

🎯 Requirements

• 10 years of related experience • comprehensive level of negotiating skills • successful track record negotiating value-based contracts with IPAs • experience reviewing medical claims data • excellent analytical and problem-solving skills • strong communication, negotiation, and presentation skills • ability to work in a matrixed organization • familiarity with legal terms in the context of provider contracting (preferred) • experience with CMS Stars and HEDIS technical specifications (preferred) • bachelor's degree preferred or a combination of professional work experience and education

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • other resources, based on eligibility