VP, Total Cost of Care - HCB
CVS Pharmacy - Hartford, CT
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Job DescriptionThe Vice President, Health Care Benefits (HCB) Cost of Care will play a critical role in establishing the overarching total cost of care management strategy and driving financial metrics related to membership growth in existing markets, medical cost management, and clinical quality performance. The enterprise performance responsibility will extend to working with division presidents, finance, shared services, medical and clinical directors as well as growth partner leads to drive overall performance including growth, margin enhancement, and thought leadership. Position will work closely with the CFO of Aetna and other SVP's on overall margin enhancement and improved programs to drive quality and health outcomes across the markets. The VP of Cost of Care will serve as a strategic thought partner to guide HCB cost of care strategy at the executive level and drive transformative change and differentiated affordability for HCB. Key to success in this position is the ability to work across the organization at all levels creating partnerships to drive growth. The VP of Cost of Care will be responsible for assisting with financial planning, establishment of financial and operating metric targets, and ongoing financial oversight and reporting. They will help effectively manage health care spend, overseeing efficient internal finance operations and driving significant, positive, and sustainable change in the company's financial and operating performance.Key Responsibilities: Provides analytical support to the Cost of Care and/or Provider Contracting organizations. Focuses efforts on lowering claims costs, improving the quality of care, and increasing member and provider network satisfaction. Provides financial and operational analysis as well as strategic direction regarding cost of care to Medicare, Medicaid, and Commercial business leaders. Partners heavily with Finance, MEU, Network, Clinical to enable effective design and execution of an enterprise cost of care strategy. Holistic and integrated solutioning across the local markets to drive and help implement cost of care improvements. Collaborates with the HCB CFO to develop and implement key business performance measures to create line of sight for senior management. Responsible for ideating new opportunities and then reporting, monitoring, and driving medical expense initiatives. Cultivates strong internal relationships and connects with cross-functional leaders to ensure alignment. Creates, builds alignment, and implements an enterprise affordability and access to care strategy that will position HCB competitively in the marketplace. Through collaborative interface with matrix partners and multiple P&L leaders across the country, sets a multi-year strategy to make care more affordable and predictable while achieving outcomes and patient experience goals to create competitive advantage and sustainable affordability for members and customers.The VP will be responsible for assisting line of businesses in ideating and creating new opportunities to achieve an additional minimum of 10% in annualized health care medical cost savings in the first year . Metrics would include ideation of new opportunities year over year. Actionable opportunities include: Improve healthcare cost analysis to identify strategies to control costs. Identifies cost of care savings opportunities by analyzing practice patterns. Reviews results post-implementation to ensure projected cost savings are realized and recommends modifications as applicable. Recommends standardized practices to optimize cost of care.Remote - working East Coast HoursRequired Qualifications 15+ years financial management experience including strategic and business planning, accounting, and financial analysis. Medical Economics experience will be highly valued. Strong knowledge of Network will be valued Experience supporting a P&L line of business. Extensive experience in healthcare, managed care insurance and/or financial services. Strategic thinker, who is growth-oriented and can quickly understand the economics of the segment and the Company as well as the shifting needs of the states and the competitive landscape. Experience leading and operating in a matrixed environment, excelling at cross-functional collaboration. Strong strategic leadership and critical thinker with experience establishing clear long and short-term goals. Drives a culture of compliance. Aligns with the values of CVS Health - Innovation, Collaboration, Caring, Integrity, Accountability.Preferred QualificationscEducationvBusiness OverviewBring 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. 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. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Created: 2024-09-07