Contract Negotiation Manager, Medicaid

Job not on LinkedIn

🔥 1 hour ago

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $60.3k - $132.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Constructs negotiation, execution, review, and analysis of contracts. • Delivers dispute resolution and settlement negotiations with providers. • Ensures contract performance aligns with accessibility, compliance, quality, financial, and cost goals. • Establishes and implements programs and innovative initiatives for the organization to advance Contract Negotiations initiatives. • Forecasts changes within the Contract Negotiations industry, conducts business impact assessments, and develops modification strategies with the aid of process improvement methodologies. • Designs systems to recruit providers in support of network expansion and adequacy targets. • Integrates cross-functional collaboration to contribute to provider compensation and pricing development activities and recommendations for negotiations and reimbursement modeling activities. • Determines recommendations to manage cost issues and support cost-saving initiatives and settlement activities. • Assists in the management of network development, maintenance, and refinement activities and strategies in support of cross-market network management units. • Coaches more junior colleagues in techniques, processes, and responsibilities.

🎯 Requirements

• 5+ years experience in a provider relations, contracting or managed care environment • Critical thinking to maintain cost management and a fully engaged network of participating PCP or specialists. • Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, financial/contracting arrangements and regulatory requirements. • Microsoft Office/Excel proficient • Must reside in the state of Michigan and be able to travel in the state (up to 10-15%) as needed (Michigan)

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • other resources, based on eligibility