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CVS Health

Runs pharmacies, health plans and clinics

Manager, ACO Strategy & Operations

Business OperationsPosted on Nov 10
Full-timeIllinois, USARemote

About the Job

Requirements

  • A bachelor's degree is required.
  • At least five years of direct experience working in value-based care, with strong knowledge and past management of REACH and MSSP ACO programs.
  • Expertise in CMS and CMMI value-based programs.
  • Excellent communication, facilitation, and interpersonal skills, with the ability to be personable yet persistent.
  • Excellent problem-solving and analytical skills combined with sound business judgment.
  • Ability to independently pursue and implement solutions to complex problems and manage multiple priorities in a fast-paced environment.
  • Mastery of Microsoft Excel, Word, PowerPoint, and Google Suite programs.
  • U.S. work authorization is required.
  • The candidate should embody the stated Oaky values: radiating positive energy, assuming good intentions, creating an unmatched patient experience, driving clinical excellence, taking ownership and delivering results, and being relentlessly determined.

Responsibilities

  • Serve as the organizational leader for Oak Street Health's relationships with CMS and CMMI, overseeing contracting, contract implementation, operations, and ongoing partnership management.
  • Lead CMS and CMMI government program implementations independently.
  • Project-manage operational issues through resolution and proactively develop and share ideas to improve Oak Street Health workflows.
  • Support delegated activities as required, including identifying business requirements for system implementation and overseeing vendor-driven activities.
  • Analyze the financial implications of existing and potential future CMS and CMMI value-based programs, quantifying and communicating organizational risk to senior leadership.
  • Lead value-based contract negotiations, using knowledge of key contract terms and their effect on Oak Street's financial and operational performance.
  • Develop a deep understanding of organization-wide operations and workflows, including financial, data, and clinical quality workflows and their intersections.
  • Ensure continuous compliance with CMS regulations, program rules, and data submission requirements for MSSP, ACO REACH, and/or LEAD.
  • Manage the annual quality reporting process and maintain documentation and audit readiness across all participating TINs.
  • Build and nurture strategic relationships with CMS and CMMI leadership teams.
  • Collaborate with internal teams to drive strategic initiatives and resolve outstanding issues.
  • Lead proactive, strategic conversations with executives and field leadership about value-added activities and initiatives.

Desired Qualifications

  • A master's degree in Healthcare Administration, Public Health, Business Administration, or a related field is preferred.
  • Hands-on experience using population health management platforms and advanced electronic medical record integration is preferred.

About the Company

CVS Health

Runs pharmacies, health plans and clinics

CVS Health runs pharmacies, health insurance plans and medical clinics for individuals, employers and government programs across the United States. Its businesses include CVS Pharmacy, the Aetna insurer and Caremark, which manages prescription coverage and negotiates drug prices for health plans. Patients fill prescriptions in stores or by mail and receive care through walk-in clinics, primary care centers and home visits. The company earns money from prescription sales, insurance premiums, plan administration fees and clinical services, combining coverage with places to obtain treatment. Its first store opened in 1963, and its headquarters are in Woonsocket, Rhode Island.

Company size
10,001+
Company stage
IPO
Headquarters
Woonsocket, Rhode Island
Founded
1963

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