Our Ability Jobs

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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

The Lead Director, Practice Transformation plays a key role by leading transformation of the care that is delivered to our members, strengthening the patient-centric collaboration between our clinical services and our provider networks, and driving to continuous improvements in quality and patient experience, decreasing the total cost of care and ultimately translating to profitable growth. This leader manages a small team who are provider-facing with accountability to build a collaborative relationship with key clinical leaders in our provider organizations, analyze provider quantitative performance and operational capabilities and to develop and execute a strategic roadmap. This role requires significant leadership skills, executive presence, and the ability to make connections across organizations, disciplines, and levels of seniority. This leader requires frequent exposure to and engagement with executive across the organization and at provider partner organizations.

Key Responsibilities:

• Direct a small team of Clinical Strategists who are accountable for clinical outcomes, quality and patient and provider experience improvements through transformation efforts

• Hire, train, coach and provide ongoing skills development for team

• Influencing and negotiation

• Manage external partner relationships across executive, providers, and administrative staff

• Relationship building

• Medical cost, risk and quality analysis

• Transforming data to influence, engage and drive action

• Implement practices to ensure best in class and evidence-based techniques are applied to achieve quintuple aim performance

• Monitor local and regional level performance results and inform ACO leadership on performance & progress

• Engage with leaders to optimize the overall results, remove barriers, and continuously align resources to optimize measured impact to quality and efficiency

• Support provider presentations and ensure materials and resources that reflect capabilities and performance are available to support these needs and communicate a value proposition in a compelling manager

• Proactively identify opportunities for improvement, identify holistic solutions, identify best practices; participate in solutions development through business requirements, review, and approval of designed solutions, ensure team members deploy, optimize, and continuously improve

• Identify business requirement for analytic and information needs, patent-facing digital solutions, and EHR and Care Mgmt. and other technologies

• Gather, analyze, and synthesize clinical business intelligence to drive achievement of strategic business objectives

• Facilitate diverse internal and external networks as appropriate for data gathering and bestpractice identification - Leverage internal and external networking to drive optimal initiative results and knowledge/best practice transfer

• Collaborate with partners within CVS Health to:

• Document the delivery detail necessary to ensure that programs being provided are consistent with the approved clinical program design

• Meet the defined requirements

• Identify the solutions to overcome any inconsistencies

• Capture feedback from the marketplace and the provider community that will sharpen the Care Transition strategies going forward and elevate to Sr Leadership for continuous process improvement

• Motivate and mentor others to probe into technical and operational details to improved process, efficiency, and results

• Contribute to a motivated work environment by working effectively to achieve common goals

Required Qualifications

• May live anywhere in the U.S., but must work Eastern Time Zone hours.

• 10+ years of strong background in health care analysis methods and tools, clinical performance improvement (Medical Loss Ratio/MLR, Medical Expenditure Management), clinical operations in a care delivery setting, population health or care management

• 5+ years of strong Medicare and clinical program experience including clinical program delivery and performance improvement techniques on the provider side.

• 3+ years of leadership and coaching skills demonstrated, preference for prior management experience

• Experience in standard performance improvement techniques, such as DMAIC, Lean, Six sigma or other

• Demonstrated expertise interpreting population data, risk stratification

• Experience working with clinical and claims data

Preferred Qualifications

• Ability to manage multiple stakeholders, synthesize and prioritize competing needs to drive positive outcomes and relationship

• Experience as a healthcare clinical consultant is highly desirable

• Specific experience within value-based contracting, risk-bearing entity and/or an ACO model is highly desired

• Ability to design, introduce and implement programs

• Ability to collaborate with and understand the needs of C-level executive and help translate those needs to an actionable plan

• Demonstrated ability to communicate technical concepts and implications to business for policy decision makers and clients

• Outstanding verbal and written communication skills, including formal presentations for all level of management combined with strong collaboration/influencing abilities

• RN or other clinical professional licensure/experience

• Deep knowledge of health care industry, policy, research design, predictive modeling, alternative payment mechanisms and risk-based/ACO finance methods and tools

• Strategic business acumen and proven organizational management and leadership skills

• Collaborative style, with ability to influence diverse team and build strong relationships

• Demonstrated strategic thinking problem solving and critical thinking abilities

• Proven success leading direct, indirect, and virtual team in a matrixed environment

• Ability to negotiate complex and often contentious issues; reach consensus and work through people to achieve key goals

• Financial acumen and experience with accountable care financial models

Education

• Bachelor's degree required or equivalent experience may be considered.

• Master's degree in related field preferred: MBA, MHA, MPH or other Health professional degree preferred (RN, other)

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.

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 Benefits | CVS Health (https://jobs.cvshealth.com/us/en/benefits)

We anticipate the application window for this opening will close on: 02/28/2025

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.