Lead Director, Provider Performance, CVS Health

CVS Health

Location:
United States, Remote

Category:
Health and Beauty

Contract Type:
Employment contract

Salary:

100000.00 - 231540.00 USD / Year

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Job Description:

This position will support primarily Georgia and the Gulf States markets, given the current VBC footprint and overall complexity of operations in these areas. Role will support VBC contracting efforts, stronger payer-provider relationships and improved financial performance. This position is accountable for the strategic alignment, operational success, and performance management of assigned provider relationships with the most complex/high value initiatives and/or highest risk and revenue generating provider systems, network and value-based relationships. Ensures that assigned value-based contract arrangements are functioning successfully and working to improve quality of care while reducing costs.

Job Responsibility:

Provider Relationship Management - Understands the terms of the value-based contract arrangements to answer questions/address issues
Responsible for establishing and maintaining productive, professional relationships
Educates internal and external parties as needed to ensure compliance with contract terms and expectations
Coordinates and prepares for external provider meetings and ensures that the most impactful internal subject matter experts are utilized to optimize performance
Assists with workflow development and strategies to integrate data and reporting
Works independently to manage relationships and identify/implement solutions to problems
Drives provider performance and partners with local market to ensure pathways to performance against business and team objectives
Drives improvement in deal performance for multiple lines of business, complex models, and/or advanced national provider partners
Leverages reporting/data to monitor contract performance against financial, clinical, cost and efficiency targets
Identifies improvement opportunities
Provides strategy consultation on actions/tactics to make needed improvements

Requirements:

Minimum 10+ years of experience in network relations, VBC arrangements, and performance management in a health plan, health system or provider organization
ACO / managed-care experience preferred
Proven expertise in contract language and interpretation, financial modeling, and/or risk-based arrangements
Strong analytical skills with the ability to assess provider performance and financial impact
Self-directed individual with independent problem-solving skills
Proven ability to interact with, influence and collaborate with internal and external stakeholders at all levels
Experience managing matrixed environment with ability to leverage internal business partners to complete tasks
Good interpersonal and communication skills
Knowledge of healthcare and insurance industry
Ability to form strong client relationships
Bachelor's degree preferred in business administration, HealthCare Administration, or a related field or equivalent work experience

Nice to have:

ACO / managed-care experience preferred
Bachelor's degree preferred in business administration, HealthCare Administration, or a related field

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
No-cost wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
November 03, 2025

Expiration:
November 23, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Lead Director, Provider Performance