Manager, Network Relations

Emploi pas sur LinkedIn

🕒 il y a 4 jours

🥔 Idaho, Ohio, +1 états de plus – Distant

🥔 Idaho – Remote 🏈 Ohio – Remote 🤠 Texas – Remote

💵 $60 300 - $132 600 / an

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

👔 Manager

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CVS Health

Site WebLinkedInTous les Emplois

10 000+ employés

Fondée en 1963

⚕️ Assurance santé

🛒 Commerce de détail

🧘 Bien-être

Healthcare Insurance • Retail • Wellness

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

• Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with solo, small group, or local providers • Manages contract performance in support of network quality, availability, and financial goals and strategies • Recruits providers as needed to ensure attainment of network expansion and adequacy targets • Collaborates cross-functionally to contribute to provider compensation and pricing development activities and recommendations • Identifies and recommends solutions to manage cost issues and supports cost-saving initiatives • Provides network development, maintenance, and refinement strategies in support of the cross-market network management unit • Assists with the design, development, management, and/or implementation of strategic network configurations and integration activities • Optimizes interactions with assigned providers and internal business partners to manage relationships • Ensures resolution of escalated issues related to claims payment, contract interpretation, and the accuracy of provider contract or demographic information

🎯 Exigences

• 5+ years of experience negotiating contracts with ancillary providers, facilities, and physician groups • Expertise in contract language development, rate proposal analysis, and operational and financial improvement opportunities • 3+ years of experience in provider relationship management or related healthcare roles • 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 • Proficiency with Microsoft Office suite applications (e.g., Outlook, Word, Excel) • Ability to build collaborative relationships with providers and work cross-functionally to resolve complex contract issues • Highly organized, with the ability to manage and prioritize multiple negotiations and tasks to meet deadlines • Bachelor's degree or a combination of professional work experience and education

🏖️ Avantages

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