Job DescriptionAs the US Healthcare System transitions to a value based payment model, Health Plans are increasingly beingmeasured and rewarded based on performance across a variety of clinical and operational quality measures. Performing well on these measures can result in specific rewards including, but not limited to, financial bonuses, increasedenrollment through beneficiary preferences and higher levels of auto-enrollment. With its wide array of assets, CVS Health is uniquely positioned to support our health plan clients in meeting their quality performance goals. Adherence tomedication is critical to improving health outcomes and reducing healthcare costs. As a result, quality measures pertaining to medication adherence and gaps in care are at the core of the Medicare Star Ratings Quality program. As the Clinical Stars Program Strategy & Development Director, you will be accountable to the performance of Caremark’s most strategic and complex Medicare Health Plan clients with over 7M lives on the Clinical Stars adherenceand medication gaps measures. You will provide leadership to multiple levels of colleagues and professional staff, as well as partner with and influence a wide set of internal and external partners at all levels of leadership including externalvendors, clients and internal operational partners, to develop and execute the Clinical Stars program strategy responsible for driving significant year over year performance improvement to attain 4 Star goals. The success in this role will require a passion and proven ability to design, develop and build solutions to drive step change improvement in all aspects of our existing suite of programs to achieve world-class Clinical Stars ratings, to improve health outcomes, and manage costs for our clients. You will also be responsible for, and measured against, the following primary objectives: · Program Strategy: o Define the strategy to apply the existing suite of solutions to drive maximum impact to 4 Star goals, including leading the evaluation of program effectiveness and prioritization of recommended interventions to inform allocation of resourceswith highest return on investment. · Program Optimization: o Build a roadmap of strategic improvement opportunities to drive step change improvements across all aspects of program delivery, including initiatives that will ensure accurate contact information for all members; improve ability to reach members through enhanced algorithms to inform out bound call campaign timing/prioritization; and improve successful call completions through end to end evaluation of member touch points to identify opportunities to increaseawareness, motivate behavior change and reinforcement.
Additionally, the Director will be accountable to partnering with Operational leaders to define and implement a center of excellence model for the pharmacist and technician resources who deliver clinical interventions. o Scale novel, proven interventions incubated and tested by the Clinical Stars Innovation team. Serve as a strategic thought partner to the Clinical Stars Innovation Director to define future vision and roadmap. · Program Execution: o Deliver flawless execution of prioritized initiatives by establishing strong operational oversight processes to identify and align all required resources to deliver campaigns, including expense forecast, IT systemic changes, labor modelfor pharmacist, technician and agent. o Rigorously monitor for performance risk and improvement opportunities by overseeing the development of action oriented program reporting to highlight performance against leading indicators, as well as in-year evaluation of impact on engaged vs. non-engaged members. · Performance Forecasting and Analysis: o Lead analytical resources to develop sophisticated methods to project performance and evaluate effectiveness of programs throughout the measurement period, as well as derive insights into client or industry performance that will inform actions to drive continuous performance improvement. · Build a High Performing Team: o Responsible for defining the organizational design and selecting the best talent with a range of diverse background and experiences to achieve the Clinical Stars agenda. As a successful Director, you will possess the ability to independently set the agenda, align stakeholders to the agenda, set accountability to achieve flawless execution provide project management leadership. You will develop a track record in building consensus and cultivating relationships with internal and external technical and business staff. You will need extraordinary written communication, oral communication, and presentation skills in order to strategically plan, organize, and time manage.
You will be required to have impeccable attention to detail, with excellent social skills. Finally, you should successfully be able to work cross-functionally to implement new requirements and creative solve problems where standard resolutions do not exist. The contributions you will make as the Director Clinical Stars Program Strategy & Development will position CVS Health as a leader in client satisfaction and service in the PBM marketplace. Required Qualifications
Preferred QualificationsDirect PBM experience is preferred. * Previous experience with Star Ratings/Quality Programs is desiredEducationBachelor's degree is required; equivalent work experience may substitute. MBA is preferred.Business Overview
|8+ years of demonstrated leadership experience within product management, strategy, operations or a similar field, within a highly regulated industry including the following:|
* 5+ years of client relationship management experience, with the demonstrated ability to analyze and resolve client issues.
gather business requirements, with a strong understanding of a technical process flow and complex requirements.
* 3+ years of advanced-expert level experience using the Microsoft Office Suite, specifically with Excel, Power Point, Outlook, Word, and Project.
* Must have the ability and flexibility to travel up to 25%.
CVS Health, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units – MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.
CVS Health is an equal opportunity employer. We do not discriminate in hiring or employment against any individual on the basis of race, ethnicity, ancestry, color, religion, sex/gender (including pregnancy), national origin, sexual orientation, gender identity or expression, physical or mental disability, medical condition, age, veteran status, military status, marital status, genetic information, citizenship status, unemployment status, political affiliation, or on any other basis or characteristic prohibited by applicable federal, state or local law. CVS Health will consider qualified job candidates with criminal histories in a manner consistent with federal, state and local laws. CVS Health will not discharge or in any other manner discriminate against any Colleague or applicant for employment because such Colleague or applicant has inquired about, discussed, or disclosed the compensation of the Colleague or applicant or another Colleague or applicant. Furthermore, we comply with the laws and regulations set forth in the following EEO is the Law Poster: EEO IS THE LAW
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For inquiries related to the application process or technical issues please contact the Kenexa Helpdesk at 1-855-338-5609. For technical issues with the Virtual Job Tryout assessment, contact the Shaker Help Desk at 1-877-987-5352. Please note that we only accept resumes via our corporate website: https://jobs.cvshealth.com/