The Senior Manager of Medicaid Provider Performance is a vital role in advancing the organization's value-based care (VBC) strategy for the Illinois Medicaid Market. This position is essential to developing and managing provider relationships that drive improved health outcomes, cost efficiency, and compliance with state and federal Medicaid obligations. Critical will be developing and implementing strategic initiatives to increase provider readiness from traditional fee-for-service models to value-based care models.
Key Responsibilities- Serve as the primary point of contact for strategic provider relationships, providing day-to-day support for contract-related needs.
- Perform market analyses to identify provider candidates for value-based contracts and initiate conversations with those groups.
- Analyze complex data and translate findings into actionable insights, including provider performance trends, utilization patterns, cost drivers, and priorities for improved outcomes.
- Act as a liaison between data analytics teams and providers to support effective use of and access to reporting and ensure providers obtain the intended value from data.
- Monitor financial performance related to value-based care contracts and identify opportunities for cost savings and utilization improvement.
- Regularly provide leadership with recommendations based on network trends to guide decision-making and advance strategic goals and objectives.
- Facilitate meetings with internal and external executive stakeholders to review performance, recommendations, and opportunities for improvement.
- Identify areas to improve processes and efficiency, including through the use of AI tools and/or automation.
Required Qualifications- 5+ years of experience in healthcare contracting, operations, data analytics, or a related role.
- 3 years of account management or client service experience
- Excellent verbal and written communication skills
- Experience developing clear, concise, and impactful materials for internal and external audiences.
- Experience using data management and analysis tools, such as Excel, SQL, data visualization software, and/or AI solutions, to identify trends, gaps, and improvement opportunities.
- Detail-oriented, organized, and able to manage multiple projects simultaneously.
Preferred Qualifications- In-depth knowledge of Medicaid reimbursement models, value-based care, and shared risk arrangements.
Education- Bachelor's degree or equivalent work experience
Pay RangeThe 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.
Great benefits for great peopleWe take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 08/22/2026
