Manager - Medical Economics

Medicare Advantage Value-Based Contract Manager

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate.

This position is accountable for the strategic alignment, operational success and performance management of Medicare Advantage Value-Based Contracts (VBC), by ensuring that VBC arrangements function successfully and work to improve quality of care while reducing costs. This role will serve as the analytics partner for VBC contracts, working with both internal and external partners, to provide medical cost and outcomes focused analytical research, financial modeling, and business decision support.

Responsibilities include :

• Understand the terms of the VBC arrangements to answer questions, address issues, and provide analytical support
• Establish and maintain productive relationships with high-value initiatives and / or highest risk and revenue generating provider systems, networks and value-based relationships
• Set the tone for the VBC relationships for both internal and external partners
• Educate internal and external parties as needed to ensure compliance with contract terms and expectations
• Assist with workflow development and strategies to integrate data and reporting
• Work independently to manage relationships and identify / implement solutions to problems
• Drive provider performance and partner with local market to ensure pathways to performance against business and team objectives
• Leverage reporting / data to monitor contract performance against financial, clinical, cost and efficiency targets
• Perform complex financial assessments
• Identify areas where improvements need to be made
• Advise and counsel network partners on value-based negotiations, deal terms and best practices
• May serve as a mentor to team members assisting with onboarding and problem solving
• May be assigned to represent the business / function on special projects
• This is an individual contributor role

Required Qualifications include :

Preferred Qualifications include :

Anticipated Weekly Hours : 40

Time Type : Full time

Pay Range : $60,300.00 - $145,860.00

We take pride in our comprehensive and competitive mix of pay and benefits investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be.

Great benefits for great people include :