Senior Manager, Provider Contracting – National Specialty Value Based Care Partnerships

This is a fully remote position, open to applicants in Alabama, +43 more states.

📋 Description

• Assist in identifying, assessing, and finalizing contracts with specialty and Medicaid provider partners.

• Build and nurture relationships with leaders of specialty or Medicaid provider organizations to develop and implement growth strategies.

• Educate leaders about the specialty landscape and financial models within the industry.

• Collaborate with the finance team to create financial models and establish value-based care contracts.

• Work alongside Network and Segment teams to effectively roll out value-based care strategies on schedule.

• Conduct competitive market analysis and devise innovative value-based payment concepts in conjunction with contracting and clinical teams.

• Collaborate across functions to develop and launch model solutions, pilot initiatives, and ensure initial return on investment for enterprise scaling.

• Act as a liaison between internal stakeholders, operations, actuarial, product, and analytics teams to guarantee that reimbursement initiatives fulfill both internal and external customer requirements.

⛳️ Requirements

• Over 7 years of experience in value-based care contracting, provider relations, provider operations, and/or solutions.

• Required experience in Medicaid or Medicare contracting; experience with large specialty groups is preferred.

• Proficient in Value-Based Care financial models.

• Familiarity with risk-based arrangements and value-based care in government services.

• Strong skills in execution and delivery, including planning, implementation, and support.

• Excellent organizational skills and attention to detail while functioning in a highly matrixed environment.

• Capability to present and simplify complex data into easily understandable information.

• A Bachelor’s degree is preferred, along with specialized training or relevant professional qualifications.

🏝️ 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.

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