CVS Health

Chantilly, VA

Lead Business Consultant

Posted 5 days ago

Job Description

Job Description
Senior Business Consultant with deep expertise in CMS, CMMI, Medicaid and ACO payment models. With particular focus and expertise in the area of Advanced Payment models and how these models align to ActiveHealth Managements core capabilities. In addition, this role would consultant with ActiveHealth Management (AHM) leadership to outline business opportunities and how to position AHM programs and services to meet and exceeds these payors expectations.

The role will develop business within government advance payment programs and expand services within ACOs. It is important to understand the competitive landscape and equally important to recommend pursuing opportunities in which AHM has a high likelihood of success. The role requires the ability to anticipate future CMS/CMMI and state initiatives, interpret CMS/CMMI and state guidance and participate in forums to share insights and promote solutions.

Required Qualifications
*Highly skilled at navigating C-Suite relationships at large complex health systems e.g. Trinity, Sutter Health.
*Existing CMS/CMMI relationships at top of agency
*Deep understanding of CMMI Alternative Payment Models and Clinical Design
*Clinical knowledge around seriously ill populations and credibility with Physician executives.
*Ability to effectively lead people without a formal reporting relationship

Preferred Qualifications
* Ability to work in highly matrixed organization to effectively communicate CMS/CMMI or State Medicaid Program Opportunities, Requirements, Obstacles, Competition to AHM Senior Leadership.
* Deep knowledge of CMS/CMMI Program requirements and strong background regarding State Medicaid programs.
* Strong communication skills to be able to bridge internal AHM programs into CMS/CMMI and Medicaid programs.
* Ability to work with Marketing Organization on our Value Proposition, participate in Key Forums as a subject matter expert and thought-leader to influence overall policy outside of AHM.
* Excellent organizational skills to communicate program requirements to be operationalized by AHM Implementation and Product teams.
* Work collaboratively to assure that all parties are clear on program measures of success.

Advanced Clinical Degree PharmD or MD

Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

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