Senior Manager, VBS Provider Performance - Texas

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

At Aetna Better Health of Texas, we are committed to helping people on their path to better health. By taking a total and connected approach to health, we guide and support our members so they can get more out of life, every day. We are looking for people like you who value excellence, integrity, caring and innovation. As an employee, you'll join a team dedicated to improving the lives of Texas members. We value diversity and are dedicated to helping you achieve your career goals.

Position Summary

Accountable for the strategic alignment, operational success and performance management. Assigned to VBS Providers limited to only one line of business (Medicaid) and/or less complex VBS Medicaid models and smaller provider partnerships (small Physician practices, small-medium sized health systems).

Ensures that assigned VBC arrangements are functioning successfully and working to improve quality of care while reducing costs.

Primary Job Duties & Responsibilities:

• Understands the terms of the VBC arrangements to answer questions/address issues. Responsible for establishing and maintaining a productive, professional relationships

• Sets the tone for the relationship

• Educates internal and external parties as needed to ensure compliance with contract terms and expectations

• Coordinates and prepares for external provider meetings and ensures that the most impactful internal subject matter experts (clinical, pharmacy, financial, analytical, etc.) are utilized in order to optimize performance. (External meetings include JOCs, clinical meetings, Informatics discussions, contract reconciliations, etc.)

• Responsible for driving improvement in deal performance

• Leverages reporting/data to monitor contract performance against financial, clinical, cost and efficiency targets.

• Identifies areas where improvements need to be made

• Provides strategy consultation on actions/tactics to make those improvements

Required Qualifications

• 3+ years' experience in Medicaid Managed Care with a strong knowledge of Value Based Contracting and/or Provider Performance

• Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills

• Microsoft Office/Excel proficient

• Strong presentation skills

• Ability to travel in assigned territory up to 25% of the time

Preferred Qualifications

Preferred Location: Houston, Texas market

Education

Bachelor's Degree or equivalent work experience

Pay Range

The typical pay range for this role is:

$75,400.00 - $166,000.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 08/26/2024