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About the Role

As a Senior Manager of Provider Performance, your role is pivotal in guiding healthcare providers toward achieving optimal outcomes in value-based care, ultimately improving patient health and well-being while effectively managing costs. Critical will be developing and implementing strategic initiatives to increase provider readiness from traditional fee-for-service models to value-based care models.

Responsibilities

• Conduct in-depth analysis of contractual performance metrics related to value-based care, including utilization measures, benchmarking, cost-effectiveness, and patient outcomes.
• Interpret and translate complex data into actionable insights for healthcare providers, helping them understand and improve their performance.
• Monitor financial performance related to value-based care contracts and identify opportunities for cost savings, risk adjustment and revenue enhancement.
• Develop strategies to actively involve patients in their care and treatment plans.
• Implement patient education programs to promote health and prevent avoidable healthcare utilization.
• Provide constructive feedback and coaching to healthcare providers, offering guidance on how to enhance their practices to align with value-based care goals.
• Evaluate and recommend technology solutions that support value-based care initiatives, including electronic health record (EHR) optimization and other relevant tools.
• Identify and implement innovative technologies and solutions that support value-based care delivery and improve patient outcomes.
• Develop and deliver training programs to educate healthcare providers and staff on best practices in value-based care delivery, reporting suite, and program goals.
• Assist in the development and implementation of risk stratification models to identify high-risk patients and tailor care interventions accordingly.
• Collaborate on the development of strategies to actively engage patients in their care, promoting preventive measures and improving overall health outcomes.
• Routine operational huddles will be mandated to ensure ancillary departments have ongoing intervention.

Requirements

• Bachelor's degree or commensurate work experience in consulting, business administration, or economics.
• 5+ years of experience in healthcare data analytics, administration, or a related role.
• In-depth knowledge of healthcare regulations, value-based care, and performance metrics.
• Strong analytical and problem-solving skills, with the ability to interpret complex data sets and identify improvement opportunities.
• Excellent communication and interpersonal skills to collaborate effectively with providers, team members, and stakeholders at all levels.
• Proven experience in designing and delivering training programs or educational initiatives.
• Proficiency in data management and analysis tools, such as Excel or data visualization software.
• Detail-oriented, organized, and able to manage multiple projects simultaneously.
• Ability to work independently, demonstrate initiative, and drive results in a fast-paced environment.
• Secure home network required.
• Familiarity with Microsoft Office products and VPN.
• Familiarity with electronic health record systems and healthcare information technology (nice to have).

Skills

• Analytical Skills
• Communication Skills
• Problem-Solving
• Interpersonal Skills
• Knowledge of Value-Based Care Models
• Change Management
• Technology Proficiency
• Educational Facilitation

Location

• Remote

Work Type

• Full-time

Experience Level

• Senior Manager
• 5+ years of experience

Education Level

• Bachelor's degree

Salary/Compensations

• $67,900.00 - $199,144.00

Benefits

• Medical coverage
• Dental coverage
• Vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• CVS Health bonus
• Commission
• Short-term incentive program
• Equity award program

About the Company

• 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.
• 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.

Equal Opportunity

• Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.