Practice Transformation Associate

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.This is a Field based role requiring 50% travel with in the state of Florida. Candidates must reside within one of the following counties to be considered:

• We are hiring one new colleague for Miami Dade County, Broward County ( will be traveling in Miami Dade County)
• We are hiring new colleague Brevard, Orange, Osceola, or Seminole

The Practice Transformation Associate builds positive relationships between Aetna Better Health (ABH) and its high-volume providers to facilitate high quality care for members. The Liaison achieves this goal through analyzing and sharing provider performance metrics related to quality, clinical outcomes, coding, and utilization used to support ABH programs. They will be a liaison between ABH providers and in select markets will be a part of a model consisting of an internal, cross-functional team of clinical, analytics, provider relations and medical personnel. The PTA will work both internally and externally with some travel time in the field to assigned provider offices.

Required Qualifications

• Bachelor's degree in healthcare or related discipline or three years of relevant work experience or
• Three years' experience in practice management or an administrative leadership role in primary care setting or
• Three years' experience in managed care with a focus on HEDIS and Quality with experience facilitating and leading meetings with provider offices and proven track record of improving performance with your market
• Knowledge of HEDIS and Pay for Performance metrics, ICD-10 coding, Medicaid risk adjustment methodology, and common billing and common billing practices
• Demonstrated understanding of Medicaid industry standards and NCQA requirements
• Proficient in Microsoft Office tools
• Strong analytical skills regarding HEDIS metrics and quality reporting
• Articulate and professional communication skills, both verbally and written
• An ability to travel (up to three days a week) across the assigned territory for in-person provider support
• Valid driver's license in good standing and access to a reliable vehicle required with insurance.
• Demonstrated experience in leading significant cross-functional work that includes business owners, executive leadership, and peers across the organization

Preferred Qualifications

• RHI, RHIT, CRC, or CPC certified Coder or auditor (CMAS) or
• RN or LPN or LISW or
• Three years' experience in managed care with a focus on HEDIS and Quality
• Ability to manage relationships with an emphasis on internal and external mid-level relationships
• Ability to work across all levels of the organization, including working with executive audiences, vendors, and government as a customer
• Demonstrated ability to project manage and implement strategies to improve performance

Education

• Bachelor's degree in healthcare or related discipline or three years of relevant work experience or
• Three years' experience in practice management or an administrative leadership role in primary care setting

Anticipated Weekly Hours
40Time Type
Full timePay Range

The typical pay range for this role is:$54,300.00 - $119,340.00This 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.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 peopleWe 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/benefitsWe anticipate the application window for this opening will close on: 08/01/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.