Sr Manager, Provider Delegation

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Must be available to work Eastern Time hours of 9:00am - 5:00pm

The Senior Manager, Provider Delegation role is critical to the on-going management of provider delegates as part of a Value Based Contract. This role sits within the Provider Clinical Strategy Delegation team providing clinical and operational oversight for providers who manage Utilization Management (UM) and/or Population Health Management (PHM) services on behalf of Aetna. The role will aid in the identification, implementation and post-implementation activities of existing and future delegates.

The role includes, but is not limited to:

• Project Management functions to successfully implement new delegates which includes collaborating with others to resolve inquiries, challenges and to help influence successful delegation setup outcomes. Includes evaluating potential delegates for capabilities that support operational & clinical successes

• Partner with network VBS Delegation team to work directly with provider delegates

• Support on-going quality of implemented delegates to ensure accuracy & builds processes/programs that drives improvements

• Improves total cost of care tied to delegation outcomes

Required Qualifications

• Experience working with clinical leaders within the organization as well as with external providers

• 7-10 years’ work experience in a healthcare setting

• Effective problem solving and decision-making skills

• Demonstrates collaboration and teamwork

• Presents a growth mindset (agility and developing yourself and others) skills

• Strong execution and delivery (planning, delivering, and supporting) skills

Preferred Qualifications

• Experience and/or extensive knowledge of the Aetna UM operational functions & related system functionality

• Knowledge of Care Management functions/activities

• Clinical background

Skilled In:

• Strong relationship builder with strong passion for innovation and collaboration.

• Effective communicator with strong verbal and written presentation abilities.

• Strong meeting facilitator with ability to drove consensus across competing point of views.

Ability To:

• Generate enthusiasm, commitment, and alignment among multiple constituents

• Influence stakeholders without authority.

• Manage complex projects.

• Understand the big picture and influence stakeholder, colleagues the right outcomes.

• Communicate effectively in a manner that is clear, logical, and consistent both verbally and written.

• Manage multiple projects simultaneously, anticipate potential issues early and adjust priorities as needed to meet outcomes.

Education

• Bachelor's degree preferred and or equivalent professional work experience

Pay Range

The typical pay range for this role is:

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. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.