R0919156 Lead Director, Provider Performance Value-Based Care (Georgia)
Position Summary
The Lead Director of Value-Based Contracting is responsible for establishing and maintaining productive value-based relationships with key network providers. Responsibilities include developing and managing the Keystone Value-based Network, building strategic relationships with provider partners, developing alternative payment models, and negotiating high-value/risk contracts.
Required Qualifications
- 10 years of related experience and comprehensive level of negotiating skills with successful track record negotiating value-based contracts with IPAs, large complex provider systems or groups, hospitals, and large physician entities.
- Experience reviewing medical claims data and developing executive summaries and identifying opportunities for mitigating medical cost trends.
- Excellent analytical and problem-solving skills.
- Strong communication, negotiation, and presentation skills.
- Ability to work in a matrixed organization and gain consensus and share information to various interested parties.
Preferred Qualifications
- Familiar with legal terms in the context of provider contracting.
- Familiar with CMS Stars and HEDIS technical specifications and various measurable percentiles associated with the HEDIS measures.
- Experience with Commercial, Medicare and Medicaid contracting.
- Able to apply system thinking when managing multiple provider value-based initiatives.
- Strong financial modeling background.
Pay Range
The typical pay range for this role is $100,000.00 - $231,540.00. This pay range represents the base hourly rate or 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 eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program.