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.
Oak Street Health, a CVS Health company, is committed to delivering high-quality care to older adults on Medicare, particularly in underserved communities. We focus on the kind of healthcare you'd want for your own family—personalized, accessible, and effective.
Our mission is to rebuild healthcare around wellness and positive outcomes, not volume. Through dedicated care teams, we take the time to understand each patient and provide the support they need to live healthier, fuller lives.
We emphasize value-based care, especially full-risk/capitated models, and leverage care management strategies to improve clinical and financial outcomes.
The AVP, Admission Prevention will report to the Chief Clinical Officer and oversee the responsibility for our overall admission prevention program and will lead a full strategic revamp and implement related change for the following programs in partnership with clinical operations and field leadership:
Complex Patient Care: strategy and operations related to managing highest cost OSH patients (~10K patients), providing support for SDOH, and shaping overarching care management strategy across 300k patients.
Transitions of Care and Emergency Department (ED) Diversion: strategy and operations related to all transitions of care from the acute and post-acute (> 100K discharges per year and >200k ED visits per year).
Delegated Utilization Management / Care Management: ~150K members under delegation with > $100M of estimated annual medical cost savings.
This role will have overall P&L ownership for the Admission Prevention Team:
Provide strategic and operational leadership for Medical Management functions, including Transitions of Care, Complex Care, and Delegated UM/CM.
Create and drive an integrated strategy across transitional care, complex care, and utilization management, ensuring these functions work in concert to reduce avoidable admissions, improve patient outcomes, and manage total cost of care.
Oversee a cross-functional team that will:
Lead operations for centralized RN and MSWs cohorts and partner with field teams to drive accountability for other field-based care management roles
Drive transitional care programs aimed at preventing hospital readmissions and improving HEDIS stars performance, covering discharges from acute, post-acute, and ED settings.
Lead centralized management of the highest-cost patients ensuring optimal clinical outcomes and cost management.
Develop and implement organization-wide strategies for care management and social determinants of health, ensuring alignment with population health goals.
Oversee delegated utilization management for acute and post-acute admissions for ~50% of the patient population, ensuring compliance and seamless integration with the care model.
Partner closely with central clinical operations, population health, compliance, and finance teams to design and operationalize strategies that improve quality, cost, and patient experience.
Collaborate with field medical directors and operational leaders to ensure medical management programs are well-integrated into day-to-day practice and support local care delivery needs.
Mentor and develop leaders within the Medical Management organization, fostering a culture of accountability, innovation, and patient-centered care while strengthening cross-functional alignment across the enterprise.
Qualifications:
The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to all aspects of the company’s business, as well as significant interaction with all the business leaders. The candidate will be expected to have the following key attributes:
15+ years of applicable experience in healthcare / population health / working with healthcare providers; or other similar fields.
Strong understanding of Value Based payment mechanisms.
Background in management consulting or equivalent strategic experience.
Strong leadership skills with the ability to inspire, build trust, and influence diverse stakeholders.
Strong business and financial acumen.
Must have strong financial and operational expertise with a history of achieving results.
Ability to operationalize external vendor solutions to complex operational issues.
Established ability to develop innovative operational changes.
Demonstrate executive presence and ability to interact with internal and external constituents.
Incredible level of organization and detail orientation.
Analytical and data savvy. Ability to develop business cases, ROI analysis, and financial analysis.
Proven ability to connect the dots across teams and initiatives, proactively communicating how individual projects align with broader organizational goals.
Proficiency in Microsoft Office Suite, Google Workspace, and project management tools.
Demonstrates a pleasantly persistent approach to problem-solving and collaboration.
Brings a humble, team-oriented mindset to every interaction.
Quick to learn and thrive in environments with high levels of ambiguity and change.
Pay Range
The typical pay range for this role is:
$157,800.00 - $363,936.00
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: 12/12/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.