Health Data Lead
LivantaLLC
Lead Director, Network and Trend Optimization
CVS Health
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteSalary
💰 $100,000 - $231,540 per year
Job Level
Senior
About the role
- Act as the primary point of contact for the Central Region between network, medical economics, clinical operations, finance team, and sales teams
- Identify and implement opportunities to enhance cost efficiency and quality performance within the region
- Collaborate with Network data and analytics teams to analyze healthcare cost trends and leverage resources effectively
- Develop and execute strategic initiatives through pricing, network curation, and medical management
- Develop and implement strategies to align with network contracting priorities and commercial trend management goals
- Ensure competitive network arrangements to support cost-effective and high-quality care delivery
- Leverage high-value networks and innovative payment models to enhance care affordability and access
- Identify and execute initiatives to mitigate trends and provide competitive products
- Track and analyze industry trends and healthcare utilization benchmarks and provide actionable insights to contracting teams
- Collaborate with Local Market Trend Committees and National Commercial Trend Committees
- Partner with sales teams in top-tier priority markets to develop strategies that improve network cost position
- Participate in high-level meetings with network leadership and commercial stakeholders to present findings and drive decision-making
- Establish and oversee KPIs, create dashboards and reports, and deliver regular updates to leadership to monitor performance and ensure continuous improvement
Requirements
- Minimum of 7-10 years in healthcare industry experience, network management, contracting, trend analytics, and/or related field
- Strong understanding of healthcare systems, reimbursement models, healthcare cost trends, network contracting principles, and provider relations
- Proven ability to analyze and interpret complex data sets to develop actionable strategies
- Experience in finance, clinical operations, or network contracting
- At least 5 years in a role involving cross-functional collaboration
- Strong communication skills, including experience presenting to senior leadership
- Strong analytical abilities with proficiency in data interpretation and financial modeling
- Proven track record of implementing cost-saving initiatives without compromising quality of care
- Ability to influence and drive change within a complex organizational structure
- Preferred: Experience working with sales teams and commercial stakeholders
- Preferred: Experience with healthcare data analytics platforms and electronic health record (EHR) systems
- Preferred: Knowledge of regional healthcare regulations and reimbursement models
- Preferred: Certification in healthcare finance or management (e.g., HFMA, ACHE)
- Education: Bachelor's degree preferred in healthcare administration, Finance, Business or a related field / specialized training / relevant professional qualification
- Candidates residing in Central Region preferred
