Sr Mgr,Managed Care Operations

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.

Company: Oak Street Health

Title: Sr. Manager, Managed Care Operations

Location: Downtown Chicago (30 W. Monroe St.) or Remote

Role Description:

The Sr. Manager, Payer Partnerships and Contracting will immediately become an important leader on the Oak Street Health (OSH) team in support of Oak Street’s relationships with Medicare Advantage health plan. The ideal candidate will have strong relationship and communication skills, have excellent people leadership and management skills, be self-directed, and enjoy working with a team in a fast-paced environment, while bringing their experience and innovative ideas. Highly successful candidates will have existing familiarity with the processes and dynamics around health plan and provider relationships, ideally with those under value-based payment arrangements. 

Core Responsibilities:

• Serve as organizational leader for OSH relationships with our key payer partners, including contracting, contract implementation, operations, and ongoing management of the partnerships
• Approach health plan relationships with the mindset of a “business owner”
  • Build and nurture relationships with health plan
  • Project manage and own operational issues to resolution
  • Develop and execute strategic opportunities/financial negotiations
  • Relentlessly pursue opportunities to express the value that Oak Street delivers for health plan partners
• Proactively & professionally lead value-based contract negotiations, with strong understanding of key contract terms and the impact they have on Oak Street’s financial and operational performance
• Develop deep understanding of OSH operations and workflows across the organization, including financial, data, clinical quality, and their key intersection points with health plan processes
• Analyze financial implications of existing and potential future health plan contracts/value based programs, quantifying and communicating organizational risk to senior leadership
• Lead payer implementations independently
• Collaborate with other teams at OSH to drive strategic initiatives with payers and to resolve outstanding payer issues
• Proactively develop and share ideas for how to improve OSH workflows
• Lead conversations proactively and strategically with executives and field leadership on value-add activities and initiatives with payers
• Support delegated activities as required (e.g. identification of business requirements for system implementation, oversight of vendor driven activities)
• Manage and develop Associates
• Other duties as assigned

What we’re looking for:

Required qualifications include:

• Bachelor's degree

• Excellent communication, facilitation, and interpersonal skills with the ability to be personable yet persistent
• Exceptional people leadership and management skills
• Excellent problem-solving and analytical skills and impeccable business judgment
• Ability to independently pursue and implement solutions to complex problems
• Ability to manage multiple priorities in a fast-paced environment
• Experience managing people
• Project management skills
• Mastery of Microsoft Excel, Word, and Powerpoint
• U.S. work authorization
• Someone who embodies being “Oaky”

What does being “Oaky” look like?

• Radiating positive energy
• Assuming good intentions
• Creating an unmatched patient experience
• Driving clinical excellence
• Taking ownership and delivering results
• Being relentlessly determined

Why Oak Street Health?

Oak Street Health is on a mission to “Rebuild healthcare as it should be,” providing personalized primary care for older adults on Medicare, with the goal of keeping patients healthy and living life to the fullest. Our innovative care model is centered right in our patient’s communities, and focused on the quality of care over volume of services. We’re an organization on the move! With over 200 primary care center locations and an ambitious growth trajectory, Oak Street Health is attracting and cultivating team members who