Senior Manager, Value-Based Care Contracting

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🔥 0 minutes ago

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

💵 $67.9k - $149.3k / year

⏰ Full Time

🟠 Senior

👔 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

• Develop and manage provider relationships that drive improved health outcomes, cost efficiency, and compliance with state and federal Medicaid obligations. • Direct groups to manage provider contract performance and support the development and implementation of strategic, value-based contract relationships. • Negotiate Network contracts with healthcare providers, establish reimbursement rates, service agreements, and performance metrics. • Advise on provider performance, network adequacy, geographical coverage, and member satisfaction. • Conduct market analysis, assess competitive positioning, and recommend strategies to maintain a competitive edge.

🎯 Requirements

• Minimum 7 years of experience in provider network management, contract negotiations, or value-based contracting within Medicaid or managed care programs. • Strong understanding of Medicaid reimbursement models, value-based care, and risk sharing arrangements. • Demonstrated ability to analyze financial and quality performance data and implement process improvements. • Experience with provider performance measurement, quality improvement and building strong provider partnerships. • Reside in the Louisiana market.

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • equity award program