Responsibilities:

Provider Engagement:

Establish and maintain engagement with large provider groups that have a membership of 1,000 or greater. 2.

Performance Analysis:

Conduct comprehensive analysis of provider performance metrics as well as clinical operations for VBC readiness and risk assessment. This includes clinical quality indicators, patient and provider satisfaction ratings and operational efficiency measures. Identify areas of improvement and develop data-driven strategies to improve provider performance and financial rewards. 3.

Provider Education and Practice Transformation:

Collaborate with cross-functional teams to assess practice operations against industry best practices in primary care. Design and deliver training programs, workshops, and educational materials for primary care and specialty providers and their staff in key operational domains to achieve improved health outcomes. Facilitate sessions on clinic operations, quality standards, regulatory compliance, member experience and patient-centered care to enhance provider skills and knowledge. 4.

Performance Improvement Initiatives:

Lead initiatives aimed at improving provider performance. Develop and implement performance improvement plans, monitor progress, and evaluate the effectiveness of interventions in collaboration with practice partners. 5.

Quality Assurance:

Conduct regular audits, reviews, and assessments of provider practices, documentation and compliance. Provide feedback and recommendations for improvement. 6.

Stakeholder Collaboration:

Collaborate closely with internal teams, including clinical and operational leadership, value-based care, quality management teams and provider relations teams to align provider performance objectives with organizational goals. Foster effective working relationships with providers, offering guidance, feedback, and support to facilitate their success. 7.

Data Management and Reporting:

Utilize data management systems and analytics tools to collect, analyze, and report provider performance data. Prepare comprehensive reports, dashboards, and presentations for senior leadership, highlighting key performance indicators, trends, and improvement opportunities. 8.

Industry Knowledge and Research:

Stay abreast of industry trends, best practices, and regulatory changes related to provider performance and healthcare quality. Support population health and health equity initiatives to improve care gap closure rates and health outcomes. Conduct research and benchmarking activities to identify innovative approaches and opportunities for improvement.

Requirements:

5-7 years of experience in healthcare quality improvement, provider relations, or a related role. In-depth knowledge of healthcare regulations, clinical operations, quality standards, and performance metrics. Strong analytical and problem-solving skills, with the ability to interpret complex data sets and identify improvement opportunities. Excellent communication, presentation and interpersonal skills to collaborate with and effectively influence provider groups and executives, , team members, and stakeholders at all levels. Proven experience in designing and delivering training programs or educational initiatives. Proficiency in data management and analysis tools, such as Excel or data visualization software. Familiarity with electronic health record systems and healthcare information technology. Detail-oriented, organized, and able to manage multiple projects simultaneously. Ability to work independently, demonstrate initiative, and drive results in a fast-paced environment. Position is remote - secure home network required and familiar with Microsoft Office products and VPN - with up to 30% regional travel.

Preferred:

Licensed Allied Health Professional or Licensed Registered Nurse Coding or Provider facing, Clinical experience, or Provider Practice experience Certified Six Sigma Green Belt Certified Professional in Healthcare Quality (CPHQ) or equivalent Education/license requirements: Bachelor's degree or commensurate work experience in healthcare administration, public health, or a related field Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $54,300.00 - $159,120.00 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. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We 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. 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