Senior Network Contracting Negotiation Manager

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🕒 Agosto 7

🚗 Michigan – Remoto

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💵 $75.400 - $165.954 / ano

⏰ Tempo Integral

🟠 Sênior

👔 Gerente

👻 Score fantasma 3%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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Logo of CVS Health

CVS Health

10.000+ funcionários

Fundada em 1963

🏥 Saúde

⚕️ Seguro de Saúde

🛒 Varejo

Healthcare • Healthcare Insurance • Retail

CVS Health é uma empresa líder de saúde nos Estados Unidos, dedicada a ampliar o acesso e a acessibilidade ao cuidado. A empresa adota uma abordagem abrangente que inclui serviços de saúde, seguro saúde e gestão de benefícios farmacêuticos (PBM). Por meio de suas subsidiárias, como Aetna e CVS Caremark, a CVS Health oferece uma variedade de serviços que promovem o bem-estar, a gestão de condições de saúde e a cobertura acessível de medicamentos prescritos. A CVS Health opera farmácias de bairro, oferece serviços de farmácia por correspondência e gerencia programas de medicamentos de especialidade, com o objetivo de tornar o cuidado com a saúde conveniente e acessível para todos. Movida pela missão de conectar pessoas a serviços essenciais de cuidado, a CVS Health está comprometida em fomentar comunidades mais saudáveis e apoiar o bem-estar de todas as pessoas.

Descrição

• Negotiate complex network contracts with healthcare providers, establishing reimbursement rates, service agreements, and performance metrics • Advise on provider performance, network adequacy, geographical coverage, and member satisfaction • Make necessary network modifications or expansions • Implement improvement initiatives to ensure network providers meet regulatory and quality standards • Develop and expand the network by identifying and contracting with hospitals, physicians, specialists, and ancillary service providers • Conduct market analysis and assess competitive positioning • Recommend strategies to maintain a competitive edge • Interface with finance on budgeting, cost analysis, and financial forecasting • Manage the financial aspects of provider network management • Consult with medical directors, operations managers, and network development professionals to align performance goals • Provide continuous recommendations to senior leadership to guide decision-making and align with strategic goals

🎯 Requisitos

• 7+ years of healthcare industry experience • 5+ years of related experience • Comprehensive provider negotiating skills with a successful track record negotiating contracts with complex provider systems or groups • Must reside in Michigan • Critical thinking to maintain cost management and a fully engaged network of participating hospitals, ancillaries, and providers • Microsoft Office and Excel proficiency • Ability to travel in the assigned Michigan market up to 10–15% of the time as needed • Experience using contract management systems preferred • Relevant experience and understanding of the local healthcare market and payer dynamics preferred • Demonstrated analytical aptitude with proven capability to troubleshoot complex issues preferred • Skilled at connecting data to daily execution of tasks preferred • Bachelor’s Degree or equivalent professional work experience

🏖️ Benefícios

• CVS Health bonus, commission or short-term incentive program • Award target in the company’s 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, based on eligibility

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