Contract Negotiator Manager – Providers

Job not on LinkedIn

3 days ago

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Logo of CVS Health

CVS Health

Healthcare Insurance • Retail • Wellness

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

• Recruits providers as needed to ensure network adequacy and achievement of network expansion goals • Negotiates contracts with health care providers using pre-determined internal guidelines and financial standards • Uses various sources of competitive intel to negotiate best in market discounts • Develops rate proposals and performs financial analyses • Manages contract performance and works with various internal departments to address questions, issues, and activities related to execution, loading, and ongoing maintenance of provider contracts • Supports the negotiation and implementation of value-based contract relationships

🎯 Requirements

• 3+ years of experience negotiating contracts with ancillary providers, facilities, physician groups, and IPAs • Uses competitive and financial data to negotiate favorable contracts • Understanding of common contract provisions, provider reimbursement methodologies and terms, and industry standard payment policies and practices • Understanding of provider financial issues, regulatory requirements, and competitor strategies • Demonstrates high proficiency with Microsoft Office suite applications (e.g., Outlook, Word, Excel, etc.) • Detail-oriented with strong communication, analytical and negotiation skills • Ability to build collaborative relationships with providers and work cross-functionally to resolve complex provider contract issues

🏖️ Benefits

• Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching • Paid time off • Flexible work schedules • Family leave • Dependent care resources • Colleague assistance programs • Tuition assistance • Retiree medical access

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