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Position SummaryThe Sr. Director of Value Based Payment Transformation (Sr. Director) is a key part of the Aetna Better Health of Virginia leadership team, reporting to the CEO. This role is responsible for the performance oversight, regulatory reporting, internal/external communications, and ongoing management and oversight of VBP contractual responsibilities with the Department of Medical Assistance Services (DMAS). The Sr. Director will work in close partnership with the CEO, COO, CFO, and all internal matrixed growth partners to implement, manage, and drive the overall success of advanced Alternative Payment Models (APMs). The Sr. Director will be the primary senior leader responsible for ongoing VBP related communications and coordination with DMAS. Candidates must live in Virginia or be willing to relocate.

Provider Engagement• Development of strong relationships and provider engagement on VBP models through recurring in-person and virtual meetings with management to executive leadership of small to large provider groups and systems.• Support providers VBP readiness and success through ongoing education, surveys, VBP model overviews and performance updates. • Identify and execute performance improvement initiatives in partnership with providers and multiple internal matrixed growth partners.• Implement processes to share data and performance reports monthly with participating VBP providers.

Performance and Reporting• Partner with multiple informatics teams to design and develop advanced self-service VBP reporting and dashboards to understand actionable insights that drive multi-year strategies.• Regularly assess and communicate to internal and external stakeholders the financial performance of all implemented APMs. • Achieve annual financial performance targets tied to VBP• Leverage advanced Excel, SQL, and other analytics skills to conduct ad-hoc analysis of large data sets

Regulatory VBP implementation, management, and oversight• Implement and execute VBP contractual requirements and initiatives, including the annual updated VBP Strategic Plan to drive ongoing model improvement.• Fielding and coordinating responses to VBP related State inquiries • Conducting quality reviews of all regulatory VBP reports prior to submission• Participating in all regulatory and internal VBP workgroups/meetings and owning key action itemsRequired Qualifications• 5+ years of Value-Based / Alternative Payment Model experience across all levels of the HCP-LAN framework.• 5+ years of Medicaid payor experience• 5+ years of developing and executing project plans and engineering or re-engineering business workflows and technical processes.• 1+ years of experience interpreting and executing contractual and/or regulatory language and managing oversight of regulatory requirements.• Deep understanding of health plan operations and data, including Quality and NCQA HEDIS, provider contracting & credentialing, claims/encounters processing, utilization management, case management, network access requirements, and Medicaid eligibility and capitation.• Advanced data analytics skills, including advanced Excel, intermediate+ SQL (Power BI experience preferred)• Strong presentation skills and communication skills to executive level audiences, both written and verbal• Successfully able to navigate and influence associates across all levels in a large matrixed organization.• Excellent organization and time management skillsPreferred QualificationsIntermediate+ Power BI experienceEducationPlease replace this section with the Education Requirements

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

CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

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