Provider Performance Manager I

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.

About the role

As a Manager of Provider Solutions, 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. You will develop and implement 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, including 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.
• Report on quarterly performance, internally and externally.
• Conduct routine operational huddles to ensure ancillary departments have ongoing intervention.
• Provide education and training programs for internal staff, including healthcare providers and administrative teams, to ensure a smooth transition to value-based care.

Requirements

• 2-4 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.
• Familiarity with electronic health record systems and healthcare information technology.
• Detail-oriented, organized, and able to manage multiple projects simultaneously.
• Ability to work independently, demonstrate initiative, and drive results in a fast-paced environment.
• Position is remote – secure home network required and familiarity with Microsoft Office products and VPN.

Skills

• Analytical Skills: Proficient in analyzing healthcare data to identify patterns, trends, and areas for improvement.
• Communication Skills: Effective communication skills to convey complex healthcare data and insights to diverse audiences.
• Problem-Solving: Strong problem-solving skills to address challenges and barriers to successful value-based care implementation.
• Interpersonal Skills: Ability to build relationships and collaborate with healthcare providers, administrators, and other stakeholders.
• Knowledge of Value-Based Care Models: In-depth understanding of various value-based care models and their implications on healthcare delivery.
• Change Management: Skill in managing and facilitating change within healthcare organizations.
• Technology Proficiency: Familiarity with healthcare information systems and technologies supporting value-based care.
• Educational Facilitation: Ability to develop and deliver educational programs to diverse healthcare audiences.

Pay

The typical pay range for this role is $54,300.00 - $159,120.00 annually. This pay range represents the base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography, and other relevant factors. This position is also eligible for a CVS Health bonus, commission, or short-term incentive program in addition to the base pay range listed above.

Schedule

• Anticipated weekly hours: 40
• Time type: Full time

Benefits

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. Benefits include:

• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources, based on eligibility