Description
Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. *Position Summary* Aetna Better Health of Oklahoma, a CVS Health company, is a trusted health partner in the local Oklahoma communities we serve. We provide a full array of innovative services that enhance overall wellness and improve everyday life for our members. At Aetna Better Health of Oklahoma, we value professional development and career growth. You will work along other colleagues who align on Heart at Work behaviors and bringing your heart to every moment of health. We will support you all the way! This is a fulltime remote opportunity; Oklahoma residency is required. Travel required based on business needs. May be travel to the Oklahoma City office with greater frequency during the startup. The Sr. Mgr., Project Program Management-Value Based Solution, leads work and deliverables of multiple, complex projects or programs, including Value Based Solution programs. Position works with internal teams to develop value based strategic plan and manage contract performance with targeted provider groups to ensure we meet State guidelines for Value Based provider agreements. Additional Responsibilities: * Accountable for working with our strategic provider partners to promote innovative value-based solutions to meet total cost and quality goals. Responsible for deploying alternative payment models, executing new initiatives, which requires: * Basic understanding of the providers' volume and cost structure * Aligning negotiation tactics with goals encompassing network accessibility, quality, compliance and financial performance. * Evaluates, helps formulate, and implements the provider network strategic plans to achieve value-based contracting targets and manage medical costs through effective value-based contracting to meet state contract and product requirements. * Develops and implements strategic business plan to achieve business goals. * Proactively leads a program and/or most complex projects by setting strategic direction. * Identifies gaps and recommends enhancements related to new and/or existing products, services and workflows based on broad * view of the organization. * Collaborates and partners with other functional managers, other business areas across/within segments or other business areas to ensure all workflow processes and interdependencies are identified and addressed. * Consults with constituents (these may be internal and/or external) to scope/define project. Influences change in order to improve performance results, organization effectiveness and or systems/quality/services. * Obtains financial support for most complex projects or supports this work as it relates to program management. * Collaboratively works across multiple functions and /or segments to obtain agreement from all impacted parties (e.g., up and downstream effects often impact multiple functions and/or departments. * Responsible for development and implementation of new ideas that supports work/team. * Cross function/segment group facilitation/presentation. * Leads all project and/or program management work including monitoring and tracking of progress and status update communications. * Responsible for resource utilization within and across work teams. Responsible for the financial implications of projects and/or program budgets. Assists others to identify solutions to issues that negatively impact program and/or project plan. * Proven ability to satisfy customers' needs and develop alternatives to resolve issues. * Performs other duties as assigned. *Required Qualifications* * Resides in Oklahoma. * Experience includes development and management of multiple projects and or programs. * 3+ years' recent Managed Care Network Value Based Contracting experience * Knowledge of Medicaid Regulatory Standards for Network Access, Credentialing, Claims Processing, Provider Appeals and Disputes and Network Performance Standards * 3+ years' experience using personal computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, PowerPoint, etc.) * Strong communication, negotiation, and presentation skills * Ability to communicate effectively with all levels of management. * Exceptional verbal, written, and presentation skills. * Proven negotiation skills. * Proven track record in meeting project milestones and negotiating for resources. * Must possess reliable transportation and be willing and able to travel in-state up to 15% of the time. Mileage is reimbursed per our company expense reimbursement policy. *Preferred Qualifications* * Medicaid experience * Healthcare experience * Startup experience is a plus * Familiar with legal terms in the context of provider contracting * Able to apply system thinking when managing multiple provider value-based initiatives * Strong financial modeling background *Education* * Bachelor's degree in closely-related field or an equivalent combination of formal education and recent, related experience. *Pay Range* The typical pay range for this role is: $67,900.00 - $149,300.00 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. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit [jobs.CVSHealth.com/benefits](https://jobs.cvshealth.com/benefits) We anticipate the application window for this opening will close on: 05/12/2024
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