Lead Director, Practice Transformation - CVS Accountable Care Organization

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary
The Lead Director, Practice Transformation plays a key role by leading transformation of the care that is delivered to our members, strengthening the patient-centric collaboration between our clinical services and our provider networks, and driving to continuous improvements in quality and patient experience, decreasing the total cost of care and ultimately translating to profitable growth. This leader manages a small team who are provider-facing with accountability to build a collaborative relationship with key clinical leaders in our provider organizations, analyze provider quantitative performance and operational capabilities and to develop and execute a strategic roadmap. This role requires significant leadership skills, executive presence, and the ability to make connections across organizations, disciplines, and levels of seniority. This leader requires frequent exposure to and engagement with executive across the organization and at provider partner organizations.

Key Responsibilities:

• Direct a small team of Clinical Strategists who are accountable for clinical outcomes, quality and patient and provider experience improvements through transformation efforts
• Hire, train, coach and provide ongoing skills development for team
• Influencing and negotiation
• Manage external partner relationships across executive, providers, and administrative staff
• Relationship building
• Medical cost, risk and quality analysis
• Transforming data to influence, engage and drive action
• Implement practices to ensure best in class and evidence-based techniques are applied to achieve quintuple aim performance
• Monitor local and regional level performance results and inform ACO leadership on performance & progress
• Engage with leaders to optimize the overall results, remove barriers, and continuously align resources to optimize measured impact to quality and efficiency
• Support provider presentations and ensure materials and resources that reflect capabilities and performance are available to support these needs and communicate a value proposition in a compelling manager
• Proactively identify opportunities for improvement, identify holistic solutions, identify best practices; participate in solutions development through business requirements, review, and approval of designed solutions, ensure team members deploy, optimize, and continuously improve
• Identify business requirement for analytic and information needs, patent-facing digital solutions, and EHR and Care Mgmt. and other technologies
• Gather, analyze, and synthesize clinical business intelligence to drive achievement of strategic business objectives
• Facilitate diverse internal and external networks as appropriate for data gathering and best
  practice identification - Leverage internal and external networking to drive optimal initiative results and knowledge/best practice transfer
• Collaborate with partners within CVS Health to:
  • Document the delivery detail necessary to ensure that programs being provided are consistent with the approved clinical program design
  • Meet the defined requirements
  • Identify the solutions to overcome any inconsistencies
  • Capture feedback from the marketplace and the provider community that will sharpen the Care Transition strategies going forward and elevate to Sr Leadership for continuous process improvement
  • Motivate and mentor others to probe into technical and operational details to improved process, efficiency, and results
  • Contribute to a motivated work environment by working effectively to achieve common goals

Required Qualifications

• May live anywhere in the U.S., but must work Eastern Time Zone hours.
• 10+ years of strong background in health care analysis methods and tools, clinical performance improvement (Medical Loss Ratio/MLR, Medical Expenditure Management), clinical operations in a care delivery setting, population health or care management
• 5+ years of strong Medicare and clinical program experience including clinical progra