Senior Manager, Medical Economics

Strategic Alignment And Performance Management For Medicare Advantage Value-Based Contracts

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

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.

• 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
• May serve as a mentor to team members assisting with onboarding and problem solving
• May be assigned to represent the business/function on special projects

The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company's business, as well as significant interaction with all the business leaders. The candidate will be expected to have the following key attributes:

• Bachelor's degree along with 7+ years related experience
• Must have prior Healthcare experience
• 7+ years experience with Microsoft Office suite, especially Excel
• 7+ years demonstrated experience success analytic, strategic, and time management skills
• 5+ years demonstrated success in collaborating with others to meet/exceed expectations

Preferred Qualifications:

• Experience in Medicare Advantage and/or Value Based Contracting
• Ability to remain flexible with ever changing priorities
• Strong collaboration and organization skills working across various teams
• Ability to communicate effectively with all levels
• Experience with SQL, working with large and detailed data sets

The typical pay range for this role is:

$67,900.00 - $199,144.00

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

• Affordable medical plan options, 401(k) plan (including matching company contributions), and employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.