Executive Director, Group Medicare Performance Optimization Specialist

6 days ago

Hartford, Connecticut, United States CVS Health Full time
Job Title: Executive Director, Group Medicare Performance Optimization

At CVS Health, we are committed to delivering enhanced human-centric healthcare for a rapidly changing world. As an Executive Director, Group Medicare Performance Optimization, you will play a critical role in leading our Group Medicare Performance Optimization team to drive financial strength and profitable growth in our Group Medicare business segment.

Key Responsibilities:
  • Develop annual operating plans and collaborate with Aetna and Medicare organizations to assess performance, define clear program strategies, establish outcome goals, and measure and report on performance results for GRS' Top 15 clients.
  • Design conceptual models and strategies for interdependent, cross-functional projects and initiatives to deliver holistic solutions.
  • Collaborate with Medicare finance, actuarial, and COE partners to identify areas where business performance is not running according to plan and develop remediation plans that can be executed and tracked.
  • Work closely with the Group Medicare CFO, as well as underwriting and actuarial leaders, to understand margin and revenue assumptions, assess how clients are performing relative to assumptions and/or forecasts, identify performance gaps, and build actionable recommendations to enhance and/or maintain profitability.
  • Analyze Group Medicare business performance, profitability, and trends to identify and lead business performance improvement opportunities, establish actionable insights, and formulate strategies that bolster overall business efficiency, align with financial targets, etc.
  • Design reporting frameworks and dashboards to monitor, measure, and socialize comprehensive performance results.
  • Develop and maintain a deep understanding of business impacts, internal initiatives, and metrics driving business performance.
  • Analyze and report on market intelligence factors such as industry performance trends, best practices, competitive landscapes, and relevant regulatory impacts to identify drivers for future success.
  • Communicate efficiently and effectively to translate novel strategies to audiences, including senior leadership.
  • Serve as the primary point of contact for the Medicare COE and other departments to prepare and report on ongoing business performance results, activities, and initiatives.
  • Lead the Group Medicare governance forum to communicate results, elevate issues or barriers to success, and ensure stakeholder alignment.
  • Oversee a team that collaborates closely with and functions as a direct extension of the GRS Account Management team.
Requirements:
  • 10+ years' of FP&A experience within the healthcare industry.
  • Strong knowledge of Medicare. Knowledge of Group Medicare Advantage will be highly valued.
  • Strong understanding of CMS regulations such as the Inflation Reduction Act (IRA), Medicare Prescription Payment Plan (M3P), and Indirect Medical Education (IME) Payment and their financial impacts to the Medicare Advantage program.
  • Strong financial acumen with deep experience conceptualizing new financial models, monitoring and optimizing business performance, and setting strategic direction to achieve budget goals and financial targets.
  • Advanced proficiency in Excel, Access, Tableau, and/or other data reporting software will be highly valued.
  • Demonstrated experience developing analyses, presentations, and support material to successfully implement strategy or change initiatives.
  • Ability to engage with business leaders at all levels independently and with high credibility.
  • Strategic thinker with an ability to influence and to be innovative and resourceful in developing solutions.
  • Proven ability to solve complex issues and manage multifaceted business relationships.
  • Adept at building consensus with stakeholders with regards to strategy/direction, execution, and delivery.
  • High degree of comfort and fluency in flexing between strategic, big-picture thinking and tactical, detail-orientation execution.
  • Strong mastery of problem-solving, teamwork, and collaboration.
  • Highly motivated self-starter with a growth mindset.
  • Confidence and courage to work independently, execute priorities, identify, and initiate improvements without requiring step-by-step direction.
What We Offer:
  • A competitive salary range of $131,000 - $303,195.00.
  • A bonus, commission, or short-term incentive program.
  • An award target in the company's equity award program.
  • A comprehensive benefits package, including medical, dental, and vision benefits.
  • A 401(k) retirement savings plan.
  • An Employee Stock Purchase Plan.
  • A fully-paid term life insurance plan.
  • Short-term and long-term disability benefits.
  • Well-being programs.
  • Education assistance.
  • Free development courses.
  • A CVS store discount.
  • Discount programs with participating partners.
  • Paid Time Off (PTO) or vacation pay.
  • Paid holidays throughout the calendar year.

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