Contract Negotiation Manager

Job not on LinkedIn

🔥 12 hours ago

🏈 Ohio, Pennsylvania, +2 more states – Remote

🏈 Ohio – Remote 🔔 Pennsylvania – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote

💵 $60.3k - $132.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

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CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Negotiate, execute, review, and analyze contracts with solo, small-group, or local providers • Handle provider dispute resolution and settlement negotiations • Manage contract performance in support of network quality, availability, financial goals, and strategies • Recruit providers to support network expansion and adequacy targets • Collaborate on provider compensation, pricing development, contractual information, negotiation, and reimbursement modeling activities • Identify and recommend solutions for cost issues and support cost-saving initiatives and settlement activities • Perform network development, maintenance, and refinement activities • Assist with strategic network configuration and integration activities • Optimize interactions with assigned providers and internal business partners • Resolve escalated issues involving claims payment, contract interpretation, contract parameters, and provider contract or demographic information

🎯 Requirements

• A minimum of 5 years of experience negotiating contracts with ancillary providers, facilities, and physician groups • Experience with contract language, development and analysis of rate proposals, identifying operational and financial improvement opportunities, and collection and analysis of competitive data and key financial metrics • 3+ years of experience in provider relationship management or related healthcare roles • Proficient contract management skills • 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 • High proficiency with Microsoft Office suite applications, including Outlook, Word, and Excel • Ability to build collaborative relationships with providers and work cross-functionally to resolve complex provider contract issues • Ability to manage and prioritize multiple negotiations, issues, and tasks to meet deadlines • Experience with Commercial and Medicare lines of business preferred • Bachelor's degree preferred or a combination of professional work experience and education

🏖️ Benefits

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

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