Provider Contracting Senior Manager, National Specialty Value Based Care Partnerships Remote

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.

Aetna is recruiting for a Senior Manager; Value Based Contractor supporting Medicare and Medicaid and will partner with business development and network leaders to build innovative and strategic provider relationships as part of the National Value Based Solutions Specialty Partnership team. You will work collaboratively across the Network and Clinical organizations to ensure speed in market and to support segment leaders with growing our Specialty and Medicaid VBC portfolio.

·         Supporting the process for identifying, evaluating, and completing contracting with Specialty and Medicaid provider partners.

·         Developing relationships with leaders of specialty or Medicaid provider organizations to design and execute on strategies for growth.

·         Develop and educate leaders on specialty landscapes and what financial models are being used across the industry.

·         Partnering with finance on the development of financial models and VBC contracts to support portfolio growth.

·         Partnering with Network and Segment teams to ensure deployment of VBC strategies are executed timely.

·         Perform market competitive analysis, engage contracting and clinical teams to create innovative value-based payment concepts.

·         Work with cross functional teams to create and initiate model solution development, pilot models, and ensure initial ROI for enterprise scaling.

·         Serve as a liaison among internal customers, operations, actuary, product, and analytic teams to ensure reimbursement initiatives meet the needs of internal and external customers.

·         7+ years of experience in value-based care contracting, provider relations, provider operations and/or solutions.

·         Medicaid or Medicare contracting experience required, working with large specialty groups preferred

·         Experience in Value Based Care financial models.

·         Experience in Risk-based arrangements and Value-Based care in government services

·         Adept at execution and delivery (planning, delivering, and supporting) skills.

·         Strong organization and detail skills working in a highly matrixed environment.

·         Ability to present and translate complex data into digestible information.

·         Bachelor’s degree preferred/specialized training/relevant professional qualification.

The typical pay range for this role is: