Lead Director, Network Management (Value-Based Care)

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OperationsManagement

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Quick Summary

Key Responsibilities

Provider Relationship Management - Understands the terms of the value based contract arrangements to answer questions/address issues. Responsible for establishing and maintaining productive,

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OperationsManagement

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

**This person must sit in KY, IL, MO, MN, WI, SD, ND, IN, IA, CO, OH, KS, NE, MI**

Responsibilities

~2 min read

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Provider Relationship Management - Understands the terms of the value based contract arrangements to answer questions/address issues. Responsible for establishing and maintaining productive, professional relationships.
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Educates internal and external parties as needed to ensure compliance with contract terms and expectations
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Coordinates and prepares for external provider meetings and ensures that the most impactful internal subject matter experts (clinical, pharmacy, financial, analytical, etc.) are utilized to optimize performance. (External meetings include JOCs, clinical meetings, Informatics discussions, contract reconciliations, etc.)
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Assists with workflow development and strategies to integrate data and reporting
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Works independently to manage relationships and identify/implement solutions to problems
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Drives provider performance and partners with local market to ensure pathways to performance against business and team objectives
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Drives improvement in deal performance for multiple lines of business, complex models, and/or advanced national provider partners
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Leverages reporting/data to monitor contract performance against financial, clinical, cost and efficiency targets. Adept at identifying issues or trends in reporting.
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Assumes supervisory responsibilities for VBS Provider Performance team members Identifies improvement opportunities. Provides strategy consultation on actions/tactics to make needed improvements
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Assists Executive Director, Provider Performance, in developing and driving strategies to achieve organizational goals
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Serves as support and back-up to Executive Director, Provider Performance, as needed
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Drives and monitors consistency and adherence to policies/protocols of department
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Assists in identification and promotion of best practices within Team
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Identifies training and/or educational needs within Team
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Oversees training plan for new Team colleagues

Requirements

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10 years experience in a health plan, health system or provider organization, ACO / managed-care experience preferred.
Strong understanding of Medicaid products, provider engagement, and regulatory compliance requirements.
Experience directly managing people and/or Teams
Self-directed individual with independent problem-solving skills
Proven ability to interact with, influence and collaborate with internal and external stakeholders at all levels
Experience managing matrixed environment with ability to leverage internal business partners to complete tasks
Good interpersonal and communication skills
Knowledge of healthcare and insurance industry
Ability to form strong client relationships

Adept at collaboration and teamwork with both internal and external partners
Experience with Provider Contracting, Plan Design and Product Offerings

Bachelor's degree preferred or a combination of professional work experience and education.

The typical pay range for this role is:

$100,000.00 - $231,540.00

What We Offer

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We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 10/10/2026

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