Contract Negotiation Manager

Emploi pas sur LinkedIn

🔥 il y a 14 heures

🌵 Arizona, California, +2 états de plus – Distant

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💵 $60 300 - $132 600 / an

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

👔 Manager

🗣️🇺🇸🇬🇧 Anglais requis

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Logo of CVS Health

CVS Health

10 000+ employés

Fondée en 1963

🏥 Santé

⚕️ Assurance santé

🛒 Commerce de détail

Healthcare • Healthcare Insurance • Retail

CVS Health est une entreprise américaine de premier plan dans le domaine de la santé, dédiée à l'amélioration de l'accès et de l'accessibilité financière des soins de santé. L'entreprise s'appuie sur une approche globale qui comprend les services de santé, l'assurance santé et la gestion des prestations pharmaceutiques. À travers ses filiales, telles qu'Aetna et CVS Caremark, CVS Health propose une gamme de services qui favorisent le bien-être, la gestion des maladies chroniques et une couverture abordable des médicaments prescrits. CVS Health exploite des pharmacies de proximité, fournit des services de pharmacie par correspondance et gère des programmes de médicaments spécialisés, visant à rendre les soins de santé pratiques et accessibles à tous. Animée par une mission de connecter les individus aux services de soins essentiels, CVS Health s'engage à favoriser des communautés en meilleure santé et à soutenir le bien-être de toutes les personnes.

Description

• Negotiate, execute, review, and analyze contracts and handle dispute resolution and settlement negotiations with solo, small group, or local providers, including SCAs, LOAs, and PPAs • Manage contract performance in support of network quality, availability, and financial goals and strategies • Recruit providers to achieve network expansion and adequacy targets • Collaborate cross-functionally on provider compensation and pricing development, contractual information submission, and negotiation and reimbursement modeling reports • Identify and recommend actions to manage cost issues and support cost-saving initiatives and settlement activities • Provide network development, maintenance, and refinement activities and strategies for cross-market network management • Assist with strategic network configuration design, development, management, implementation, and integration activities • Optimize interactions with assigned providers and internal business partners to manage relationships and meet provider needs • Resolve escalated issues involving claims payment, contract interpretation and parameters, and provider contract or demographic information accuracy • Interpret contractual requirements, including federal and state regulations and NCQA standards

🎯 Exigences

• 5+ years of working knowledge of the healthcare industry, including competitor strategies, complex contracting options, financial and contracting arrangements, and regulatory requirements • 3+ years of experience in provider relationship management or related healthcare roles • Proven and proficient contract management skills • Strong communication, critical thinking, problem-resolution and interpersonal skills • Proficiency in Microsoft Office Suite, including Excel, Word, PowerPoint, and Outlook • Candidates residing on the West Coast are strongly preferred • Bachelor's degree preferred or a combination of professional work experience and education

🏖️ Avantages

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program in addition to base pay

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