Lead Director, Business Performance – Medicaid

CVS Health

. Lead development, implementation, and oversight of reporting solutions supporting strategic Medicaid programs and state-directed initiatives .

Posted 9/17/2026full-timeRemote • Illinois • United StatesSenior💰 $100,000 - $231,540 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in leading the development and implementation of reporting solutions for Medicaid programs, with a strong focus on data-driven insights, performance management, and stakeholder engagement. Proven ability to mentor teams and navigate complex organizational structures to align program goals with strategic objectives.

Highest-signal resume keywords

Medicaid Managed Care ExperienceExecutive-Level Reporting DevelopmentCross-Functional Initiative ManagementHealthcare Claims Data AnalysisTeam Leadership and Mentoring

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data AnalysisPerformance Management FrameworksKPI DevelopmentDashboard CreationOperational Recommendations

Soft Skills

Relationship BuildingStrategic CommunicationMentoringProblem SolvingLeadership

Industry Keywords

Medicaid ProgramsValue-Based CareQuality Improvement InitiativesSocial Determinants of HealthHealthcare Reimbursement Methodologies

About the role

Key responsibilities & impact

Lead development, implementation, and oversight of reporting solutions supporting strategic Medicaid programs and state-directed initiatives
Translate complex business objectives into actionable analytics, dashboards, and executive reporting
Identify opportunities to improve program performance through data-driven insights and operational recommendations
Advise executive leadership on program outcomes, emerging risks, and performance trends
Establish governance and reporting structures for state-sponsored Medicaid initiatives, financial performance and ROI, provider partnerships, community-based organization engagement, and vendor performance
Develop executive-level scorecards, KPIs, dashboards, and performance monitoring frameworks
Analyze claims, encounter, utilization, quality, and financial data
Partner with provider organizations, value-based care partners, and community-based organizations to evaluate effectiveness and outcomes
Support innovative partnerships addressing health-related social needs
Monitor partnership performance and recommend corrective actions or expansion opportunities
Establish vendor cohorts and performance segmentation strategies
Develop methodologies evaluating vendors against operational, financial, quality, and member outcome metrics
Drive accountability through performance reviews and improvement plans
Lead, mentor, and develop Senior Managers and business consultants
Build relationships with executives and senior leaders across matrixed organizations
Present results, insights, recommendations, and strategic analyses to senior leadership
Navigate complex organizational structures and lead large-scale cross-functional initiatives
Align program goals with corporate objectives, state requirements, and member needs

Requirements

What you’ll need

8+ years of progressive leadership experience in healthcare, managed care, consulting, analytics, or business strategy
5+ years leading high-performing teams and people leaders
Significant experience within Medicaid managed care organizations, state Medicaid programs, or healthcare consulting environments
Demonstrated experience working with healthcare claims and encounter data to drive strategic decision-making
Experience developing executive-level reporting and performance management frameworks
Proven success managing cross-functional initiatives involving multiple stakeholders and business units
Bachelor's degree or equivalent work experience
Preferred: experience supporting state Medicaid contracts, quality improvement initiatives, or value-based care programs
Preferred: experience working with provider organizations, community-based organizations, and external vendors
Preferred: knowledge of social determinants of health and community partnership strategies
Preferred: experience with vendor oversight and outcome-based performance measurement
Preferred: familiarity with Medicaid quality measures, regulatory requirements, and healthcare reimbursement methodologies
Preferred: experience in a highly matrixed healthcare organization

Benefits

Comp & perks

CVS Health bonus, commission or short-term incentive program
Equity award program
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being