Senior Manager, Provider Performance (New Jersey)
CVS Pharmacy - Trenton, NJ
Apply NowJob Description
Job DescriptionThe Senior Manager is accountable for the strategic alignment, operational success and performance management. Assigned to VBS Providers limited to only one line of business (Medicare or Commercial) and/or less complex VBS models (Medicare Lites, Commercial P4Ps) and less sophisticated 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: VBS PROVIDER RELATIONSHIP MANAGEMENT: (estimated % of time: 50%) 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.) DEAL PERFORMANCE MANAGEMENT: (estimated % of time: 50%) - 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 improvementsPay RangeThe typical pay range for this role is:Minimum: 75,400Maximum: 158,300Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required QualificationsProven ability to interact with, influence and collaborate with internal and external stakeholdersExperience managing matrixed environment with ability to leverage internal business partners to complete tasksKnowledge of healthcare and insurance industryAbility to form strong client relationships.Understanding of Provider Contracting, Plan Design and Product OfferingsAbility to travel regionally on quarterly basis.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications5+ years experience in a health plan, health system or provider organization, ACO / managed-care experience preferredACO / managed-care experienceGood interpersonal and communication skillsBachelor's degree preferredEducationBachelor degree or equivalent professional experience.Business OverviewBring your heart to CVS HealthEvery 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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.
Created: 2024-09-07