Lead Director, Network Management (Value-Based Care)

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.

***This person must sit in KY, IL, MO, MN, WI, SD, ND, IN, IA, CO, OH, KS, NE, MI***

Position Summary

This role will be 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. Additionally, this position will include supervisory responsibilities for VBS Provider Performance team members.

This role is strategically designed to provide dedicated leadership and oversight for Medicaid value-based care (VBC) initiatives across the Central Region. This position carries broad responsibility for the development, execution, and oversight of Medicaid focused value-based contracting and provider performance strategies within these two key markets.

Key Responsibilities

• 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 (clinical, pharmacy, financial, analyti