Senior Manager, National Network Management – National Health Systems

Job not on LinkedIn

🔥 12 hours ago

🏄 California, Florida, +4 more states – Remote

🏄 California – Remote 🐊 Florida – Remote 🎸 Tennessee – Remote 🤠 Texas – Remote ⚔️ Virginia – Remote 🍑 Georgia – Remote

💵 $67.9k - $182.5k / year

⏰ Full Time

🟠 Senior

👔 Manager

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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 and execute contracts with larger and more complex national or regional health systems, hospitals, physician groups and ancillaries • Conduct high-level contract review and analysis • Participate in dispute resolution and settlement negotiations • Design conceptual models and plan initiatives • Manage contract performance and support development and implementation of strategic provider networks • Support accessibility, quality, financial goals, cost initiatives and value-based contract relationships • Identify and manage cost issues and initiate cross-functional cost-saving or settlement activities • Collaborate cross-functionally on provider compensation, pricing development, contractual information and reimbursement modeling • Represent the company with high-visibility constituents, customers and community groups • Facilitate JOC meetings • Manage complex contractual provider relationships according to national and regional network strategies • Serve as subject matter expert for less experienced team members and internal partners • Resolve escalated issues involving claims payment, contract interpretation, contract parameters and provider information accuracy • Evaluate, formulate and implement national network strategic plans to achieve contracting targets and manage medical costs • Interpret contractual requirements, including federal and state regulations and NCQA

🎯 Requirements

• Minimum of 7 years of related experience • Minimum of 5 years of successful expert-level negotiation experience with large or complex health systems • Comprehensive negotiating skills with a successful track record negotiating contracts with individual or complex provider systems or groups • Critical thinking to maintain cost management and a fully engaged network of participating hospitals, ancillaries and providers • Healthcare industry experience with either a payer or provider • Strong communication, critical thinking, problem resolution and interpersonal skills • Working knowledge of value-based contracting • Internal Aetna system knowledge • Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, financial/contracting arrangements and regulatory requirements • Bachelor's degree preferred or a combination of equivalent work experience and education

🏖️ Benefits

• 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 • Company equity award program

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