Senior Manager, Network Management

Emploi pas sur LinkedIn

🕒 il y a 20 jours

🌶️ New Mexico, Oklahoma, +1 états de plus – Distant

infoinfo

💵 $67 900 - $165 954 / an

⏰ Temps Plein

🟠 Senior

👔 Manager

🗣️🇺🇸🇬🇧 Anglais requis

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Publiée sur la page carrières de CVS Health, pas via un site d'emploi

Repérée par Remote Rocketship il y a 20 jours

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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

• Lead end-to-end contract negotiations, execution, and analysis with hospitals, physician groups, and smaller/local systems • Manage contract performance and develop and implement value-based arrangements aligned with organizational strategy • Identify, recruit, and onboard providers to meet network expansion and adequacy targets • Deliver competitive and sustainable cost arrangements • Partner cross-functionally on provider compensation strategy, pricing development, and reimbursement modeling • Analyze financial and operational data to identify cost-saving opportunities and execute initiatives with measurable impact • 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 • 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 • Conduct high-level review and analysis, dispute resolution, and settlement negotiations of contracts

🎯 Exigences

• 7+ years of experience negotiating contracts with hospitals, facilities, and physician groups, including contract language development, rate proposal analysis, and identifying operational and financial improvement opportunities • 3+ years of experience in provider relationship management or related healthcare roles, with 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 • Ability to leverage competitive market data, financial metrics, and detailed analysis to secure favorable contract outcomes • Strong communication, critical thinking, problem resolution, and interpersonal skills • Bachelor’s degree preferred or a combination of professional work experience and education • Commercial, individual exchange, and Medicare experience preferred • Experience contracting with hospital systems and groups preferred • Advanced Excel experience, including pivot tables and VLOOKUP, preferred • Strong preference for the candidate to sit in the Dallas-Fort Worth area or Oklahoma

🏖️ Avantages

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

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🗣️🇺🇸🇬🇧 Anglais requis

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