Senior Manager, Network Contracting

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🕒 vor 7 Tagen

🌽 Illinois – Remote

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💵 $82.940 - $182.549 / Jahr

⏰ Vollzeit

🟠 Senior

👔 Manager

👻 Geisterscore 0%

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🗣️🇺🇸🇬🇧 Englisch erforderlich

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CVS Health

10.000+ Mitarbeiter

Gegründet 1963

🏥 Gesundheitswesen

⚕️ Krankenversicherung

🛒 Einzelhandel

Healthcare • Healthcare Insurance • Retail

CVS Health ist ein führendes amerikanisches Gesundheitsunternehmen, das sich der Verbesserung des Zugangs zu Gesundheitsdiensten und deren Erschwinglichkeit verschrieben hat. Das Unternehmen verfolgt einen umfassenden Ansatz, der Gesundheitsdienstleistungen, Krankenversicherungen und das Management von Apothekenleistungen umfasst. Durch seine Tochtergesellschaften, wie Aetna und CVS Caremark, bietet CVS Health eine Vielzahl von Dienstleistungen an, die Wohlbefinden, Krankheitsmanagement und erschwinglichen Versicherungsschutz für verschreibungspflichtige Medikamente erleichtern. CVS Health betreibt Apotheken in der Nachbarschaft, bietet Versandapothekendienste an und verwaltet Programme für Spezialmedikamente, um Gesundheitsversorgung für jeden bequem und zugänglich zu machen. Angetrieben von der Mission, Menschen mit wesentlichen Pflegediensten zu verbinden, ist CVS Health bestrebt, gesündere Gemeinschaften zu fördern und das Wohlbefinden aller Menschen zu unterstützen.

Beschreibung

• Negotiate, execute, conduct high-level review and analysis, and resolve disputes or conduct settlement negotiations for contracts • Manage larger and more complex market, regional, and national provider groups and systems • Contract and implement fee-for-service and value-based agreements with physician groups, facilities, and ancillary providers • Collaborate with Aetna and CVS departments to improve physician performance and quality of care • Recruit providers to achieve network expansion and adequacy targets • Manage cost arrangements within defined provider groups • Partner cross-functionally on provider compensation, pricing development, contractual information submission, and reimbursement modeling • Lead end-to-end contract negotiations, execution, and analysis • Manage contract performance and develop and implement value-based arrangements • Identify, recruit, and onboard providers • Analyze financial and operational data to identify cost-saving opportunities and execute impact-driving initiatives • Represent the organization with providers, customers, and community stakeholders • Evaluate and contribute to provider network strategy aligned with state requirements, product needs, and cost management objectives • Optimize provider engagement and resolve complex escalations involving claims, contract interpretation, and provider data accuracy

🎯 Anforderungen

• 7+ years of experience negotiating contracts with hospitals, facilities, and physician groups • Experience with contract language development, rate proposal analysis, and identifying operational and financial improvement opportunities • Ability to leverage competitive market data, financial metrics, and detailed analysis to secure favorable contract outcomes • 3+ years of experience in provider relationship management or related healthcare roles • Proven contract management expertise • Working knowledge of provider financial issues and competitor strategies • Knowledge of large/complex contracting options, financial/contracting arrangements, and regulatory requirements • Strong communication, critical thinking, problem resolution and interpersonal skills • Candidates must reside in the state of Illinois • 10% travel required • Advanced Excel experience, including pivot tables and v-lookup function • Commercial, individual exchange and Medicare experience preferred • Experience contracting with hospital systems and groups preferred • Bachelor's degree preferred or a combination of professional work experience and education

🏖️ Vorteile

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Comprehensive benefits package supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program • Award target in the company’s equity award program

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