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Position Summary
The Medicare Performance Management Lead Business Consultant will facilitate and support implementation of the business unit’s management process and operating model. This role will assist the Medicare Advantage market facing General Manager most directly, in supporting the development and execution of the market strategies, including the development of market level Medicare Advantage product and network strategies, execution of pricing commitments, and management process to ensure development and execution of the plan. Continuously improve management practices to enable collaboration and shared accountability for success. Role will report to the Head of Medicare Performance Management.

The ideal candidate will not only manage business processes, but also actively influence local market performance but help to shape and drive the markets bid strategy. The role will be an analyst of Medicare business performance, meaning that the role is expected to review both financial and medical economic information on their own, so as to be a self-guiding individual that can point to issues that need to be addressed and focused on. Helps to communicate focus activities on diagnosis i.e. unit cost / utilization / provider collaboration / revenue management. Drives execution of pricing commitments and corrective action plans. Creates a metrics driven management process that allows the segment to understand measured performance. to deliver on the strategic objectives, cost containment activity, growth objectives, and new initiatives to identify and pursue opportunities for further alignment across the Medicare Advantage market and segment leadership teams. The Lead Business Consultant role will be a liaison between senior management and local market leaders Identifies and leads process Improvement opportunities relating to Medicare Advantage Manages process for identification of areas to prioritize for performance improvement Reviews Key Performance Metrics, Helps to establish targets Brings segment/product priorities to the market for local execution. Supports Local Market General Manager Develop a project management framework for driving accountability Developing monthly Quick Strike agenda and facilitate meeting and follow-ups Management process such as Pricing Commitments, market visits, deep dives, performance/ scorecard and takeaways that align to execution of Strategy Identifying, prioritizing and driving alignment opportunities across markets Enables operating model for partnership with local General Managers, Director of Operations, CFOs, Medical Directors, Network Managers, Medical Economics, and Pricing Actuaries

Required Qualifications

-7+ of Medicare experience
-10+ years experience with several of the following methodologies: management consulting, project consulting, financial strategic analysis, strategic business planning, and/or risk management consulting. Experience with enterprise-wide and/or cross-functional large scale initiatives with high degree of complexity. Demonstrated experience successfully implementing change in complex organizations. Demonstrated superior business process, project management and organizational redesign experience. Demonstrated leadership with relevant initiatives: Business process, enterprise business project management/consulting, financial strategic planning and analysis, mergers and acquisitions, strategic planning, risk management. Demonstrated relationship management skills; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.

Preferred Qualifications:

Functional Experience

Functional - Finance - Financial analysis - P&L support/7-10 Years

Functional - Project Management - Plan management/7-10 Years

Functional - Management - Management - Process and quality improvement/7-10 Years

Technology Experience

Technical - Database - SQL Server/1-3 Years/End User

Technical - Desktop Tools - Microsoft PowerPoint/1-3 Years/End User

Technical - Database - Hyperion Essbase/1-3 Years/End User

Technical - Database - Microsoft Access/1-3 Years/End User

Technical - Database - Microsoft Excel / 5-7 years/End User

Required Skills

Creating Profitable Partnerships

Collaborating for Results

Developing and Executing Strategy

Desired Skills

Communicating for Impact

Engaging and Developing People

Education Bachelor's degree or equivalent experience

Pay Range

The typical pay range for this role is:

$100,000.00 - $231,540.00

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. 
 
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.  The Company offers a full range of medical, dental, and vision benefits.  Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.  The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.  As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. 
 
For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 11/01/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.