Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary
The Lead Director, Practice Transformation plays a key role by leading transformation of the care that is delivered to our members, strengthening the patient-centric collaboration between our clinical services and our provider networks, and driving to continuous improvements in quality and patient experience, decreasing the total cost of care and ultimately translating to profitable growth. This leader manages a small team who are provider-facing with accountability to build a collaborative relationship with key clinical leaders in our provider organizations, analyze provider quantitative performance and operational capabilities and to develop and execute a strategic roadmap. This role requires significant leadership skills, executive presence, and the ability to make connections across organizations, disciplines, and levels of seniority. This leader requires frequent exposure to and engagement with executive across the organization and at provider partner organizations.

Key Responsibilities:

Direct a small team of Clinical Strategists who are accountable for clinical outcomes, quality and patient and provider experience improvements through transformation effortsHire, train, coach and provide ongoing skills development for teamInfluencing and negotiationManage external partner relationships across executive, providers, and administrative staffRelationship buildingMedical cost, risk and quality analysisTransforming data to influence, engage and drive actionImplement practices to ensure best in class and evidence-based techniques are applied to achieve quintuple aim performanceMonitor local and regional level performance results and inform ACO leadership on performance & progressEngage with leaders to optimize the overall results, remove barriers, and continuously align resources to optimize measured impact to quality and efficiencySupport provider presentations and ensure materials and resources that reflect capabilities and performance are available to support these needs and communicate a value proposition in a compelling managerProactively identify opportunities for improvement, identify holistic solutions, identify best practices; participate in solutions development through business requirements, review, and approval of designed solutions, ensure team members deploy, optimize, and continuously improveIdentify business requirement for analytic and information needs, patent-facing digital solutions, and EHR and Care Mgmt. and other technologiesGather, analyze, and synthesize clinical business intelligence to drive achievement of strategic business objectivesFacilitate diverse internal and external networks as appropriate for data gathering and best
practice identification - Leverage internal and external networking to drive optimal initiative results and knowledge/best practice transferCollaborate with partners within CVS Health to:Document the delivery detail necessary to ensure that programs being provided are consistent with the approved clinical program designMeet the defined requirementsIdentify the solutions to overcome any inconsistenciesCapture feedback from the marketplace and the provider community that will sharpen the Care Transition strategies going forward and elevate to Sr Leadership for continuous process improvementMotivate and mentor others to probe into technical and operational details to improved process, efficiency, and resultsContribute to a motivated work environment by working effectively to achieve common goals

Required Qualifications

May live anywhere in the U.S., but must work Eastern Time Zone hours.10+ years of strong background in health care analysis methods and tools, clinical performance improvement (Medical Loss Ratio/MLR, Medical Expenditure Management), clinical operations in a care delivery setting, population health or care management5+ years of strong Medicare and clinical program experience including clinical program delivery and performance improvement techniques on the provider side.3+ years of leadership and coaching skills demonstrated, preference for prior management experienceExperience in standard performance improvement techniques, such as DMAIC, Lean, Six sigma or otherDemonstrated expertise interpreting population data, risk stratificationExperience working with clinical and claims data

Preferred Qualifications

Ability to manage multiple stakeholders, synthesize and prioritize competing needs to drive positive outcomes and relationshipExperience as a healthcare clinical consultant is highly desirableSpecific experience within value-based contracting, risk-bearing entity and/or an ACO model is highly desiredAbility to design, introduce and implement programsAbility to collaborate with and understand the needs of C-level executive and help translate those needs to an actionable planDemonstrated ability to communicate technical concepts and implications to business for policy decision makers and clientsOutstanding verbal and written communication skills, including formal presentations for all level of management combined with strong collaboration/influencing abilitiesRN or other clinical professional licensure/experienceDeep knowledge of health care industry, policy, research design, predictive modeling, alternative payment mechanisms and risk-based/ACO finance methods and toolsStrategic business acumen and proven organizational management and leadership skillsCollaborative style, with ability to influence diverse team and build strong relationshipsDemonstrated strategic thinking problem solving and critical thinking abilitiesProven success leading direct, indirect, and virtual team in a matrixed environmentAbility to negotiate complex and often contentious issues; reach consensus and work through people to achieve key goalsFinancial acumen and experience with accountable care financial models

Education

Bachelor's degree required or equivalent experience may be considered.Master's degree in related field preferred: MBA, MHA, MPH or other Health professional degree preferred (RN, other)

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: 02/28/2025

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