Lead Director, Medicare Business Consulting

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.

Fundamental Job Components:

• Manage business processes,

• Actively influence local market performance but help to shape and drive the markets bid strategy.

• An analyst of Medicare business performance, meaning that the role is expected to review both financial and medical economic information on their own.

• Self-guiding individual that can point to issues that need to be addressed and focused on.

• Communicate focus activities on diagnosis i.e. unit cost / utilization / provider collab / revenue management.

• Drive execution of pricing commitments and corrective action plans

• Create 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.

• A liaison between senior management and local market leaders.

• Lead process Improvement opportunities relating to Medicare Advantage

• Manage process for identification of areas to prioritize for performance improvement.

• Establish targets and brings segment/product priorities to the market for local execution.

• Supports Local Market General Manager

• Develop a project management framework for driving accountability.

• Develops monthly Quick Strike agenda and facilitate meeting and follow-ups.

• Manage processes 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 years of experience with several of the following methodologies: management consulting, project consulting, business process consulting, financial strategic analysis, mergers and acquisitions, strategic business planning, and/or risk management consulting.
• Experience with enterprise-wide and/or cross-functional large-scale initiatives with high degree of complexity.
• Working knowledge of Medicare and Medicare Advantage
• Experience leading business process, project management and organizational redesign.
• 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 at the senior level; capacity to quickly build and maintain credible relationships at varying levels of the organization simultaneously.
• Proficient with the use of Excel, Tableau, MS Word, PowerPoint

Education

• Bachelor's degree or equivalent work 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.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 peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 07/17/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.