Job Description Strategic Provider Partnerships Position Purpose • Support provider performance improvement strategy at the plan and provider levels • Analyze and interpret cost and quality data to interpret performance insights and prioritize provider actions • Educate providers on the use of tools and interpretation of data and identify opportunities for improvement • Understand member population and provider variation to effectively support providers with performance improvement • Provide high-level recommendations to providers regarding opportunities to optimize clinical workflow to increase member outreach and care coordination • Develop relationships with internal partners and key accounts
Lead provider and health plan strategy related to performance improvement on cost, quality, coding and member outreach and engagement. Responsible for ongoing review of performance reporting and data, interpreting and prioritizing results; utilize tools and resources to identify performance insights; work with health plan and provider functional leadership to present results and recommend actions to providers. Manage provider performance in all levels of value-based agreements, including quality & utilization pay for performance and risk contracts.
Required Qualifications 10 years in a Healthcare Delivery System Understanding of Value Based Contracting/Accountable Care and how this relates to improving the quality of care for our members through collaboration. Passion and ability to influence and drive better outcomes in healthcare delivery. Demonstrated experience in population health management and managed care
Preferred Qualifications Strong Clinical and Analytics Experience.
Education Preferred clinical experience (RN, MBA)
Business Overview At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.