Our Ability Jobs

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At Aetna Better Health of Texas, we are committed to helping people on their path to better health. By taking a total and connected approach to health, we guide and support our members so they can get more out of life, every day. We are looking for people like you who value excellence, integrity, caring and innovation. As an employee, you’ll join a team dedicated to improving the lives of Texas members. We value diversity and are dedicated to helping you achieve your career goals.

Position Summary

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, networks and value-based relationships. Ensures that assigned VBC arrangements are functioning successfully and working to improve quality of care while reducing costs. Primary Job Duties & Responsibilities:

• Responsible for establishing and maintaining productive, professional relationships with the most complex/high value initiatives and/or highest risk and revenue generating provider systems, networks and value-based relationships

• Understand the terms of the VBC arrangements to answer questions & address issues.

• Sets the tone for the relationship

• 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, analytical, etc.) are utilized in order to optimize performance. (External meetings include JOCs, clinical meetings, Informatics discussions, contract reconciliations, etc.)

• 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

• Responsible for driving improvement in deal performance for multiple lines of business with a focus on Medicaid, OR

• Responsible for driving improvement in deal performance for advanced national provider partners (Agilon, Chen Med, Aledade, Oakstreet, VillageMD, etc.)

• Leverages reporting/data to monitor contract performance against financial, clinical, cost and efficiency targets.

• Able to perform basic and/or interpret complex financial assessments

• Identifies areas where improvements need to be made

• Provides strategy consultation on actions/tactics to make those improvements

• Able to advise/counsel network partners on value-based negotiations, deal terms and best practices

• May serve as a mentor to team members assisting with onboarding and problem solving

• May be assigned to represent the business/function on special projects

Required Qualifications-7+ years' experience in Medicaid Managed Care with a strong knowledge of Value Based Contracting and/or Provider Performance-Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills- Microsoft Office/Excel proficient-Strong presentation skills-Ability to travel in assigned territory up to 25% of timePreferred QualificationsPreferred Location: Houston, Texas marketEducationBachelor's Degree or equivalent work experience

Pay Range

The typical pay range for this role is:

$100,000.00 - $231,500.00

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

We anticipate the application window for this opening will close on: 08/26/2024

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.