Manager, Medicaid Provider Performance

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🔥 0 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $66.3k - $145.9k / year

⏰ Full Time

🟢 Junior

🟡 Mid-level

👔 Manager

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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

• Serve as a trusted partner to strategic providers, resolving contract-related issues and delivering practical solutions • Lead operational processes supporting value-based care objectives • Analyze provider performance trends, utilization patterns, cost drivers, and improvement priorities • Monitor financial and clinical performance for value-based care contracts • Identify cost savings and utilization improvement opportunities • Create data-driven materials for internal and external stakeholders • Coordinate meetings with provider leadership teams to review performance and recommendations • Liaise between data analytics teams and providers to support reporting access and effective data use • Identify process and efficiency improvements using AI tools and automation

🎯 Requirements

• 2–4 years of experience in healthcare operations, data analytics, administration, or a related role • Skilled in data management and analysis tools such as Excel, SQL, data visualization software, and/or AI solutions • Ability to identify trends, gaps, and improvement opportunities • Proficient in translating complex performance information into clear, executive-ready materials • Strong communication and interpersonal skills • Ability to collaborate with internal and external stakeholders at all levels • Detail-oriented and organized • Ability to manage multiple projects simultaneously • Familiarity with Medicaid reimbursement models, value-based care, and shared risk arrangements • Bachelor’s degree or equivalent work experience

🏖️ Benefits

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