Lead Director, Network Management – Value-Based Care

This is a fully remote position, open to applicants in Colorado, +12 more states.

📋 Description

• Oversee the strategic alignment, operational success, and performance of designated provider relationships and value-based initiatives.

• Supervise Medicaid value-based contracting and provider performance strategies throughout the Central Region.

• Manage provider relationships and resolve inquiries related to value-based contracts.

• Educate both internal and external stakeholders on the terms and expectations of contracts.

• Organize external provider meetings and engage with clinical, pharmacy, financial, and analytical subject matter experts.

• Create workflows and strategies for data integration and reporting.

• Identify and implement solutions to address relationship and performance challenges.

• Enhance provider performance and collaborate with local markets on business and team objectives.

• Improve deal performance across various lines of business, complex models, and advanced national provider partners.

• Monitor contract performance against financial, clinical, cost, and efficiency targets using reports and data.

• Supervise members of the VBS Provider Performance team and pinpoint opportunities for improvement.

• Support the Executive Director of Provider Performance with organizational strategies and provide assistance as required.

• Ensure compliance with departmental policies and protocols.

• Promote best practices within the team and identify training and educational requirements.

• Oversee the onboarding and training processes for new team members.

⛳️ Requirements

• A minimum of 10 years of experience in a health plan, health system, or provider organization.

• Proven experience in directly managing individuals and/or teams.

• A self-motivated individual with strong independent problem-solving abilities.

• Demonstrated capability to interact, influence, and collaborate with internal and external stakeholders at all levels.

• Experience managing in a matrixed environment, with the ability to utilize internal business partners to complete tasks.

• Excellent interpersonal and communication skills.

• Knowledge of the healthcare and insurance sectors.

• Ability to cultivate strong client relationships.

• Experience in Provider Contracting, Plan Design, and Product Offerings.

• A Bachelor's degree is preferred or a combination of relevant professional experience and education.

• ACO/managed-care experience is preferred.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program.

• Award target in the company’s equity award program.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources to support physical, emotional, and financial well-being.