Manager, Payer Partnerships and Contracting

📌 Core Information

🔹 Job Title: Manager, Payer Partnerships and Contracting

🔹 Company: CVS Health

🔹 Location: Downtown Chicago, IL or Remote

🔹 Job Type: Full-time

🔹 Category: Health Care

🔹 Date Posted: April 16, 2025

🔹 Experience Level: 5-10 years

🔹 Remote Status: Remote OK

🚀 Job Overview

Key aspects of this role include:

• Leading relationships with large health plans, managing contracting, implementation, operations, and ongoing management.
• Analyzing financial implications of health plan contracts and collaborating with other teams to drive strategic initiatives.
• Proactively developing and sharing ideas for improving OSH workflows.
• Managing and developing Associates on the Managed Care Operations team.

ASSUMPTION: This role requires a balance of strategic thinking, operational execution, and team leadership. The ideal candidate will have a strong understanding of managed care systems and processes, as well as experience managing teams.

📋 Key Responsibilities

✅ Serve as organizational lead in OSH relationships with at least two large health plans, including contracting, implementation, operations, and ongoing management of the partnerships.

✅ Approach health plan relationships with the mindset of a \"business owner\", project-managing and owning issues to resolution, developing opportunities, and relentlessly pursuing opportunities to express the value that Oak Street delivers for health plan partners.

✅ Proactively and professionally move contract negotiations forward, with a strong understanding of key contract terms and their impact on Oak Street's financial and operational performance.

✅ Develop a deep understanding of OSH financial operations/workflows and their key intersection points with health plan processes.

✅ Analyze financial implications of existing and potential future health plan contracts, quantifying and communicating organizational risk to senior leadership.

✅ Lead payer implementations independently and collaborate with other teams at OSH to drive strategic initiatives with payers and to resolve outstanding payer issues.

✅ Support delegated activities as required, such as identification of business requirements for system implementation and oversight of vendor-driven activities.

✅ Manage and develop Associates on the Managed Care Operations team.

✅ Other duties as assigned.

ASSUMPTION: The role requires a high level of autonomy and the ability to manage multiple priorities in a fast-paced environment. Strong communication, problem-solving, and analytical skills are essential for success in this position.

🎯 Required Qualifications

Education: Bachelor's degree

Experience: 5-10 years of relevant experience, with a focus on managed care systems/processes and people management.

Required Skills:

• Excellent communication, facilitation, and interpersonal skills
• Excellent problem-solving and analytical skills and impeccable business judgment
• Ability to independently pursue and implement solutions to complex problems
• Ability to manage multiple priorities in a fast-paced environment
• Project management skills
• People management skills and/or a history of managing direct reports
• Strong MS Excel, Word, and Powerpoint skills
• U.S. work authorization
• Embodies being \"Oaky\"

Preferred Skills:

• Experience in the health care industry
• Familiarity with Oak Street Health's mission and values

ASSUMPTION: While a Bachelor's degree is required, relevant experience and a strong skill set may be considered in lieu of a specific degree.

💰 Compensation & Benefits

Salary Range: $66,330.00 - $145,860.00 per year

Benefits:

• Paid vacation, sick time, and investment/retirement 401K match options
• Health insurance, vision, and dental benefits
• Opportunities for leadership development and continuing education stipends
• New centers and flexible work environments
• Opportunities for high levels of responsibility and rapid advancement

Working Hours: Full-time (40 hours per week)

ASSUMPTION: The salary range provided is an estimate based on industry standards for similar roles. Actual compensation may vary based on factors such as experience, education, and performance.

📌 Applicant Insights

🔍 Company Context

Industry: Health Care. CVS Health is a leading health solutions company, delivering care like no one else can. They reach more people and improve the health of communities across America through their local presence, digital channels, and over 300,000 dedicated colleagues.

Company Size: 10,001+ employees. As a large organization, CVS Health offers numerous opportunities for career growth and development.

Founded: 1963. CVS Health has a long history of providing health care services and has evolved to become a comprehensive health solutions company.

Company Description:

• CVS Health is the leading health solutions company, delivering care like no one else can.
• They reach more people and improve the health of communities across America through their local presence, digital channels, and over 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses, and nurse practitioners.
• CVS Health helps people navigate the health care system and their personal health care by improving access, lowering costs, and being a trusted partner for every meaningful moment of health.

Company Specialties:

• Retail
• Pharmacy Benefits Management
• Health Insurance
• Health Care
• Pharmacy
• Care Management
• and Primary Care

Company Website: CVSHealth.com

ASSUMPTION: CVS Health's extensive resources and reach allow them to provide comprehensive health care services and support to a wide range of patients.

📊 Role Analysis

Career Level: Mid-level management. This role involves leading a team and managing strategic partnerships with health plans.

Reporting Structure: The Manager, Payer Partnerships and Contracting will report directly to the Senior Director of Managed Care Operations.

Work Arrangement: This role is remote-friendly, with the option to work from the Downtown Chicago office or remotely.

Growth Opportunities:

• Proven success in this role may lead to advancement opportunities within the Managed Care Operations team or other areas of the organization.
• CVS Health's large size and diverse business segments offer numerous career growth paths for motivated employees.
• Oak Street Health's focus on primary care and value-based care provides opportunities to gain expertise in innovative health care delivery models.

ASSUMPTION: The Manager, Payer Partnerships and Contracting role offers a unique blend of strategic and operational responsibilities, providing an ideal platform for career growth and development.

🌍 Location & Work Environment

Office Type: CVS Health's Downtown Chicago office is a modern, collaborative workspace designed to support productivity and innovation.

Office Location(s): 1 CVS Drive, Woonsocket, RI; 950 West John Carpenter Freeway, Ste 1200, Irving, TX; 620 Epsilon Dr, Pittsburgh, PA; 2211 Sanders Road, Northbrook, IL; and remote work options.

Geographic Context:

• Chicago, IL is a major metropolitan area with a diverse economy and a thriving health care industry.
• The Downtown Chicago office is conveniently located near public transportation and numerous amenities.
• Remote work options provide flexibility and the ability to work from home or other locations.

Work Schedule: Full-time, with a flexible schedule that may include occasional evenings or weekends to accommodate partner needs.

ASSUMPTION: The remote-friendly work arrangement and flexible schedule provide a good work-life balance for employees, while also accommodating the needs of health plan partners.

💼 Interview & Application Insights

Typical Process:

• Online application submission
• Phone or video screen with the Managed Care Operations team
• In-person or virtual interview with the Senior Director of Managed Care Operations and other team members
• Final interview with the Oak Street Health leadership team
• Background check and onboarding

Key Assessment Areas:

• Communication and interpersonal skills
• Problem-solving and analytical skills
• Business judgment and strategic thinking
• Project management skills
• People management skills and cultural fit

Application Tips:

• Tailor your resume and cover letter to highlight your relevant experience and skills for this role.
• Demonstrate your understanding of managed care systems and processes, as well as your familiarity with Oak Street Health's mission and values.
• Prepare for behavioral interview questions that focus on your problem-solving skills, leadership style, and ability to manage multiple priorities.

ATS Keywords: Payer partnerships, contracting, managed care, health plans, strategic initiatives, team leadership, problem-solving, analytical skills, business judgment

ASSUMPTION: The interview process will focus on assessing the candidate's skills and cultural fit for the role and the organization.

🛠️ Tools & Technologies

• Microsoft Office Suite (Excel, Word, Powerpoint)
• Project management tools (e.g., Asana, Trello, JIRA)
• Health care-specific software and systems (e.g., Epic, Cerner, Allscripts)

ASSUMPTION: The Manager, Payer Partnerships and Contracting will need to be proficient in Microsoft Office Suite and project management tools, as well as familiar with health care-specific software and systems.

👔 Cultural Fit Considerations

Company Values:

• Customer focus
• Collaboration
• Innovation
• Performance
• Integrity

Work Style:

• Fast-paced and dynamic
• Collaborative and team-oriented
• Results-driven and accountable
• Adaptable and open to change

Self-Assessment Questions:

• How do you approach building and maintaining strong relationships with external partners?
• Describe your experience managing a team in a fast-paced environment.
• How do you balance strategic thinking with operational execution?

ASSUMPTION: CVS Health values employees who are customer-focused, collaborative, innovative, and results-driven. Candidates should be able to thrive in a fast-paced, dynamic work environment and be adaptable to change.

⚠️ Potential Challenges

• The role requires managing multiple priorities and balancing strategic and operational responsibilities.
• Health care industry dynamics and regulations may present unique challenges and complexities.
• Remote work may require additional self-motivation and time management skills.
• CVS Health's large size and diverse business segments may present opportunities for career growth, but also competition for advancement.

ASSUMPTION: The Manager, Payer Partnerships and Contracting role offers a unique blend of strategic and operational responsibilities, providing an ideal platform for career growth and development. However, the role also presents challenges that require strong communication, problem-solving, and leadership skills.

📈 Similar Roles Comparison

• Unlike other management roles, this position focuses specifically on payer partnerships and contracting, requiring a unique blend of strategic and operational skills.
• The health care industry is dynamic and complex, with unique regulations and market pressures that may differ from other industries.
• Career paths in health care may vary depending on the specific organization and role, with opportunities for growth and advancement in various areas of the business.

ASSUMPTION: The Manager, Payer Partnerships and Contracting role is unique within CVS Health and the broader health care industry. While there may be similarities to other management roles, the specific focus on payer partnerships and contracting sets this position apart.

📝 Sample Projects

• Negotiating and implementing a new contract with a major health plan, including managing the associated implementation project and ongoing relationship management.
• Analyzing the financial implications of existing health plan contracts and developing strategies to mitigate organizational risk.
• Collaborating with other teams to drive strategic initiatives with payers, such as value-based care pilots or quality improvement projects.

ASSUMPTION: The Manager, Payer Partnerships and Contracting role involves a wide range of projects, from strategic contract negotiations to operational implementation and ongoing relationship management. Successful candidates will have experience managing similar projects and be able to adapt to the unique challenges and complexities of the health care industry.

❓ Key Questions to Ask During Interview

• Can you describe the team structure and dynamics within the Managed Care Operations team?
• How does Oak Street Health approach value-based care and partnerships with health plans?
• What are the key priorities for this role in the first 30, 60, and 90 days?
• How does CVS Health support the growth and development of employees in this role?
• What are the most challenging aspects of this role, and how can I best prepare for them?

ASSUMPTION: Asking thoughtful questions during the interview process demonstrates your interest in the role and provides valuable insights into the organization and team dynamics.

📌 Next Steps for Applicants

To apply for this position:

• Submit your application through this link
• Tailor your resume and cover letter to highlight your relevant experience and skills for this role, with a focus on managed care systems/processes and people management.
• Prepare for behavioral interview questions that focus on your problem-solving skills, leadership style, and ability to manage multiple priorities.
• If selected for an interview, be prepared to discuss your understanding of the health care industry and your familiarity with Oak Street Health's mission and values.
• Follow up with the hiring manager within one week of your interview to express your continued interest in the role.

⚠️ This job description contains AI-assisted information. Details should be verified directly with the employer before making decisions.