Sr Mgr., Medicare Performance Management

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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.

Position Summary

This position is available throughout the United States. We are seeking a Senior Manager for the Medicare Performance Management Department to support the Lead Director and AVP. You will support via data pulling, data processing, conceptual model design, initiative planning, product management, performance management, and monitoring of member experience. You will be involved in the annual bid process and support high value initiatives of variable scale and complexity. These initiatives will impact the delivery of all Medicare products and services. In this role you will work with other business units across the Medicare segment on a variety of projects including, but not limited to, pulling and interpretating data, new process implementation, and ongoing operations of services, as well as troubleshooting complex issues.

Additionally, the Senior Manager will:

• Identify opportunities for improvement, influence change through negotiation, consultation, and other actions that lead to improved performance.

• Provide guidance and collaborate with external and internal partners in support of initiatives.

• Support coaching and assist in the development of matrixed staff by providing direction, oversight, and feedback on work assignments.

• May be responsible for concurrent initiatives as a team lead and/or team member, based on resource requirements.

Required Qualifications

• Basic knowledge of Individual and Group Medicare.

• Proficiency in Statistical Analysis System (SAS) and Structured Query Language (SQL) or similar programing experience.

• 3 or more years of experience with Medicare, with an emphasis in Medicare operations, performance management, strategy, bid planning, and/or data analysis.

• Strong business acumen.

• Strong organizational/time management skills.

• Effective communication skills with ability to clearly articulate information to a wide range of audiences, including senior leadership.

• Excellent problem-solving capabilities, taking a proactive approach to identifying potential areas of improvement.

• Proven experience working effectively on projects and initiatives with cross-functional teams involving a variety of stakeholders.

• Quality review experience with a commitment to ensuring accuracy and compliance.

• Ability to prioritize and handle multiple work tasks on an ongoing basis.

• Positive presence with an ability to inspire others.

• Collaboration and relationship management skills, with the capacity to quickly build and maintain credible relationships at varying levels of the organization.

• Occasional travel may be required.

*This is an individual contributor role.

Preferred Qualifications

• 5 or more years of experience with Medicare, with an emphasis in Medicare operations, performance management, strategy, bid planning, and/or data analysis.

• Actuarial background

​Education

Bachelor’s degree or equivalent work experience

Pay Range

The typical pay range for this role is:

$82,940.00 - $182,549.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.  This position also includes an award target in the company’s equity award program. 
 

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