Lead Director, Network Management

Job not on LinkedIn

🕒 May 22

🐎 Kentucky – Remote

🐎 Kentucky – Remote

💵 $100k - $231.5k / year

⏰ Full Time

🟠 Senior

👔 Director

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

⚕️ Healthcare Insurance

🛒 Retail

🧘 Wellness

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

• Accountable for developing strategic partnerships for the Kentucky Medicaid Health Plan • Focus on designing conceptual models and negotiating high value contracts • Contracting responsibilities include Medicaid and managing provider compensation • Collaborates cross-functionally to manage provider compensation and pricing development activities • Responsible for identifying and managing cost issues and collaborating on cost-saving initiatives • Represents company with high visibility constituents • Promotes collaboration with internal partners • Evaluates, helps formulate, and implements the provider network strategic plans • Helps mentor and develop others within the department

🎯 Requirements

• A minimum of 10 years related experience • Expert level negotiation skills with a successful track record negotiating contracts • Demonstrated experience in Medicaid provider contracting • Hands-on experience with Behavioral Health (BH) network development and contracting • Proven ability to manage the end-to-end contracting lifecycle • Strong knowledge of Medicaid regulations • Experience developing or supporting value-based arrangements • Demonstrated ability to build, manage, and grow strategic relationships • Experience presenting complex information to groups

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • comprehensive benefits package designed to support physical, emotional, and financial well-being