Lead Director, Provider Transformation - Active Health

Job DescriptionWe are seeking qualified candidates across the country for this work at home Lead Director role within our Active Heath teamThis role plays a key role by leading transformation of the care that is delivered to our members, strengthening the patient-centric collaboration between ActiveHealth DCE 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 efforts- Hire, train, coach and provide ongoing skills development for team - Influencing and negotiation - Relationship building - Medical cost, risk and quality analysis - Transforming data to influence, engage and drive action- Implement practices to ensure best in class and evidence-based techniques are applied to achieve quintuple aim performance- Monitor local, regional and DCE level performance results and inform DCE leadership on performance & progress- Engage with leaders to optimize the overall results, remove barriers, and continuously align resources to optimize measured impact to quality and efficiency- Support provider, DCE, and government presentations and ensure materials and resources that reflect DCE capabilities and performance are available to support these needs and communicate a value proposition in a compelling manager- Proactively 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 improve- Identify business requirement for analytic and information needs, patent-facing digital solutions, and EHR and Care Mgmt. and other technologies- Gather, analyze, and synthesize clinical business intelligence to drive achievement of strategic business objectives- Facilitate 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 transfer- Collaborate with partners within ActiveHealth and CVS Health to: - Document the delivery detail necessary to ensure that programs being provided are consistent with the approved clinical program design - Meet the defined requirements - Identify the solutions to overcome any inconsistencies- Capture feedback from the marketplace and the provider community that will sharp the Care Transition strategies going forward and elevate to Sr Leadership for continuous process improvement- Motivate and mentor others to probe into technical and operational details to improved process, efficiency, and results- Contribute to a motivated work environment by working effectively to achieve common goalsRequired QualificationsRequired Skills:Strong Medicare and clinical program experience including clinical program delivery and performance improvement techniques on the provider side. Leadership and coaching skills demonstrated, preference for prior management experience Ability to manage multiple stakeholders, synthesize and prioritize competing needs to drive positive outcomes and relationship Demonstrated expertise interpreting population data, risk stratification Experience in standard performance improvement techniques, such as DMAIC, Lean, Six sigma or other Experience as a healthcare clinical consultant is highly desirable Specific experience within value-based contracting, risk-bearing entity and/or an ACO model is highly desired Ability to design, introduce and implement programs Outstanding communication skills - both oral and written Outstanding presentations skillsQualifications: 10+ years strong background in health care analysis methods and tools, clinical performance improvement, clinical operations in a care delivery setting, population health and care management Ability to collaborate with and understand the needs of C-level executive and help translate those needs to an actionable plan Demonstrated ability to communicate technical concepts and implications to business for policy decision makers and clients Outstanding verbal and written communication skills, including formal presentations for all level of management combined with strong collaboration/influencing abilities Deep knowledge of health care industry, policy, research design, predictive modeling, alternative payment mechanisms and risk-based/ACO finance methods and tools Strategic business acumen and proven organizational management and leadership skills Collaborative style, with ability to influence diverse team and build strong relationships Demonstrated strategic thinking problem solving and critical thinking abilities Proven success leading direct, indirect, and virtual team in a matrixed environment Ability to negotiate complex and often contentious issues; reach consensus and work through people to achieve key goals Financial acumen and experience with accountable care financial models Experience working with clinical and claims dataCOVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred QualificationsRN or other clinical professional licensure/experienceEducationBachelor's degree requiredMaster's degree in related field preferred: MBA, MHA, MPH or other Health professional degree preferred (RN, other)Business OverviewAt Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.

Created: 2026-03-07