We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Position Summary
This position is accountable for the strategic alignment, operational success and performance management of Medicare Advantage Value-Based Contracts (VBC), by ensuring that VBC arrangements function successfully and work to improve quality of care while reducing costs. This role will serve as the analytics partner for VBC contracts, working with both internal and external partners, to provide medical cost and outcomes focused analytical research, financial modeling, and business decision support.
Responsibilities
- Understand the terms of the VBC arrangements to answer questions, address issues, and provide analytical support
- Responsible for establishing and maintaining productive, professional relationships with the most complex/high value initiatives and/or highest risk and revenue generating provider systems, networks and value-based relationships
- Sets the tone for the VBC relationships for both internal and external partners
- Educates internal and external parties as needed to ensure compliance with contract terms and expectations
- Influence and/or assist workflow development and strategies to integrate data and reporting
- Works independently to manage relationships and identify/implement solutions to problems
- Drives provider performance and partners with local market to ensure pathways to performance against business and team objectives
- Leverages reporting/data to monitor contract performance against financial, clinical, cost and efficiency targets
- Able to perform complex financial assessments
- Identifies areas where improvements need to be made
- Advocates-for and drives strategy consultation on actions/tactics to make those improvements
- Responsible for advising network partners on value-based negotiations, deal terms and best practices
Minimum Requirements
Bachelor's degree or equivalent experience
7+ years of experience in healthcare analytics and managed care.
Extensive knowledge of VBC strategies, provider contracting, and regulatory impacts.
Advanced communication and presentation skills.
Knowledge of marketplace healthcare delivery and understanding of provider relationships.
Pay Range
The typical pay range for this role is:
$75,400.00 - $165,954.00
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.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Skills Required
- Bachelor's degree or equivalent experience
- 7+ years of experience in healthcare analytics and managed care
- Extensive knowledge of value-based care (VBC) strategies, provider contracting, and regulatory impacts
- Advanced communication and presentation skills
- Knowledge of marketplace healthcare delivery and provider relationship management
What We Do
CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.
