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  • Manager, Provider Solutions

    CVS Health (Springfield, IL)



    Apply Now

    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. And we do it all with heart, each and every day.

     

    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 managing costs effectively. In 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:

    Core Responsibilities:

    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. Collaboration with Clinical Teams:

     

    - Collaborate with clinical leaders to integrate value-based care principles into clinical practice, emphasizing preventive care, care coordination, and patient engagement.

     

    - Collaborate with leadership to establish goals aligned with value-based care principles for initiatives to continuously improvement in care delivery, patient satisfaction, and cost-efficiency.

     

    6. Care Coordination Optimization:

     

    - Work with internal and external healthcare teams to improve care coordination efforts, ensuring seamless transitions of care and effective communication among providers.

     

    7. 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.

     

    8. Educational Support:

     

    - Develop and deliver training programs to educate healthcare providers and staff on best practices in value-based care delivery.

     

    9. Risk Stratification:

     

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

     

    10. Patient Engagement Strategies:

     

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

    Key Skills:

    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.

     

    - 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.

    Qualifications:

    + Bachelor's degree or commensurate work experience in healthcare administration, public health, or a related field.

    + 3-5 years of experience in healthcare change management, provider relations, 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 familiar with Microsoft Office products and VPN

    Preferred:

    + Six Sigma Green Belt, Licensed Allied Health Professional, or Licensed Registered Nurse

    + Certified Professional in Healthcare Quality (CPHQ) or equivalent

     

    Anticipated Weekly Hours

     

    40

     

    Time Type

     

    Full time

     

    Pay Range

    The typical pay range for this role is:

    $66,330.00 - $145,860.00

     

    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.

     

    Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

     

    Great benefits for great people

     

    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. In addition to our competitive wages, our great benefits include:

     

    + **Affordable medical plan options,** a **401(k) plan** (including matching company contributions), and an **employee stock purchase plan** .

    + **No-cost programs for all colleagues** including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

    + **Benefit solutions that address the different needs and preferences of our colleagues** including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

     

    For more information, visit https://jobs.cvshealth.com/us/en/benefits

     

    We anticipate the application window for this opening will close on: 07/20/2025

     

    Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

     

    We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

     


    Apply Now



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