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Position Summary
Candidates for this role must reside in Louisiana.
The Sr. Director of Value Based Payment Transformation (Sr. Director) is a key part of the Aetna Better Health of Louisiana leadership team, reporting to the CEO. This role is responsible for the performance oversight, regulatory reporting, internal/external communications, and ongoing management and oversight of VBP contractual responsibilities with the Louisiana Department of Health (LDH). The Sr. Director will work in close partnership with the CEO, COO, CFO, and all internal matrixed growth partners to implement, manage, and drive the overall success of advanced Alternative Payment Models (APMs). The Sr. Director will be the primary senior leader responsible for ongoing VBP related communications and coordination with DMAS. Candidates must live in Louisiana or be willing to relocate.
Responsibilities include:
Provider Engagement
• Development of strong relationships and provider engagement on VBP models through recurring in-person and virtual meetings with management to executive leadership of small to large provider groups and systems.
• Support providers VBP readiness and success through ongoing education, surveys, VBP model overviews and performance updates.
• Identify and execute performance improvement initiatives in partnership with providers and multiple internal matrixed growth partners.
• Implement processes to share data and performance reports monthly with participating VBP providers.
Performance and Reporting
• Partner with multiple informatics teams to design and develop advanced self-service VBP reporting and dashboards to understand actionable insights that drive multi-year strategies.
• Regularly assess and communicate to internal and external stakeholders the financial performance of all implemented APMs.
• Achieve annual financial performance targets tied to VBP
• Leverage advanced Excel, SQL, and other analytics skills to conduct ad-hoc analysis of large data sets
Regulatory VBP implementation, management, and oversight
• Implement and execute VBP contractual requirements and initiatives, including the annual updated VBP Strategic Plan to drive ongoing model improvement.
• Fielding and coordinating responses to VBP related State inquiries
• Conducting quality reviews of all regulatory VBP reports prior to submission
• Participating in all regulatory and internal VBP workgroups/meetings and owning key action items
Required Qualifications
· 3+ years of Value-Based / Alternative Payment Model experience
· 3+ years of Medicaid payor experience
· 1+ years of experience interpreting and executing contractual and/or regulatory language and managing oversight of regulatory requirements.
· Deep understanding of health plan operations and data, including Quality and NCQA HEDIS, provider contracting & credentialing, claims/encounters processing, utilization management, case management, network access requirements, and Medicaid eligibility and capitation.
· Advanced data analytics skills, including advanced Excel, intermediate+ SQL (Power BI experience preferred)
· Strong presentation skills and communication skills to executive level audiences, both written and verbal
· Successfully able to navigate and influence associates across all levels in a large matrixed organization.
Excellent organization and time management skills
Preferred Qualifications
5+ years of developing and executing project plans and engineering or re-engineering business workflows and technical processes.
Education
Bachelor's Degree or equivalent experience
Pay Range
The typical pay range for this role is:
$100,000.00 - $231,540.00
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 02/28/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.