Directed Provider Payment Analyst

Position Summary The Manager, Managed Care Directed Payments is a strategic leadership role responsible for the design, implementation, and ongoing management of Directed Payment Programs (DPPs) in alignment with SoonerSelect requirements and Oklahoma Health Care Authority (OHCA) guidelines. This role serves as a critical liaison between OHCA, internal teams (including Claims, Finance, and Compliance), and external provider partners. The Manager ensures accurate and timely payment execution, foster strong provider relationships, and maintains full compliance with evolving regulatory requirements. As a designated key staff position, this role plays a vital part in supporting organizational success within Oklahoma’s Medicaid managed care environment and must be based in Oklahoma. Key Responsibilities Lead the development, execution, and optimization of Directed Payment Programs (DPPs) Ensure compliance with SoonerSelect and OHCA regulatory and reporting requirements Partner cross-functionally with Claims, Finance, Compliance, and other internal teams to ensure accurate payment processing Act as the primary point of contact for providers, addressing complex payment issues and strengthening engagement Monitor program performance, identify risks, and implement process improvements Interpret regulatory guidance and translate requirements into actionable operational processes Support audits, reporting, and documentation related to directed payment programs Provide leadership across cross-functional initiatives, driving alignment and outcomes Required Qualifications 5+ years of healthcare experience, with a strong background in claims operations Demonstrated experience partnering directly with healthcare providers to resolve complex issues Solid understanding of Medicaid managed care, payment methodologies, and regulatory frameworks Proven leadership skills with the ability to manage cross-functional initiatives and stakeholders Preferred Qualifications Direct experience with SoonerSelect Medicaid managed care programs Advanced knowledge of Medicaid payment methodologies and state/federal regulatory requirements Ideal will reside in Oklahoma Education Bachelor’s degree in healthcare administration, Business, Finance, or related field (or equivalent experience) Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $54,300.00 - $119,340.00 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. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 06/13/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. 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. #J-18808-Ljbffr CVSHealth