Sr Manager, Provider Performance

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.

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. Here's an overview of the responsibilities and key skills associated with this role:

• 1. Performance Analysis:

  • Conduct in-depth analysis of contractual performance metrics related to value-based care, including utilization measures, benchmarking, cost-effectiveness, and patient outcomes.

• 2. Data Interpretation:

  • Interpret and translate complex data into actionable insights for healthcare providers, helping them understand and improve their performance.

• 3. Financial Management:

  • Monitor financial performance related to value-based care contracts and identify opportunities for cost savings, risk adjustment and revenue enhancement.

• 4. Patient Engagement:

  • 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.

• 5. Technology Utilization:

  • 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.

• 6. Educational Support:

  • Develop and deliver training programs to educate healthcare providers and staff on best practices in value-based care delivery, reporting suite, and program goals.

• 7. Risk Stratification:

  • Assist in the development and implementation of risk stratification models to identify high-risk patients and tailor care interventions accordingly.

• 8. Patient Engagement Strategies:

  • Collaborate on the development of strategies to actively engage patients in their care, promoting preventive measures and improving overall health outcomes.

• 1. Analytical
  
  Skills:

  • Proficient in analyzing healthcare data to identify patterns, trends, and areas for improvement.

• 2. Communication
  
  Skills:

  • Effective communication skills to convey complex healthcare data and insights to diverse audiences.
  • Ability to independently facilitate meetings with executive stakeholders
  • Report on quarterly performance, internally and externally.

• 3. Problem-Solving:

  • Strong problem-solving skills to address challenges and barriers to successful value-based care implementation.

• 4. Interpersonal
  
  Skills:

  • Ability to build relationships and collaborate with healthcare providers, administrators, and other stakeholders

• 5. Knowledge of Value-Based Care Models:

  • In-depth understanding of various value-based care models and their implications on healthcare delivery.

• 6. Change Management:

  • Skill in managing and facilitating change within healthcare organizations.
  • Routine operational huddles will be mandated to ensure ancillary departments have ongoing intervention

• 7. Technology Proficiency:

  • Familiarity with healthcare information systems and technologies supporting value-based care.

• 8. Educational Facilitation:

  • Ability to develop and deliver educational programs to diverse healthcare audiences
  • Provide education and training programs for internal staff, including healthcare providers and administrative teams, to ensure a smooth transition to value-based care.

• Bachelor's degree or commensurate work…