Senior Manager, Network Contracting

Job not on LinkedIn

🔥 15 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $82.9k - $182.5k / year

⏰ Full Time

🟠 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

• 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 impactful initiatives • 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 related to claims, contract interpretation, and provider data accuracy • 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

🎯 Requirements

• 7+ years of experience negotiating contracts with hospitals, facilities, and physician groups • Experience with contract language development, rate proposal analysis, and identifying operational and financial improvement opportunities • Ability to leverage competitive market data, financial metrics, and detailed analysis to secure favorable contract outcomes • 3+ years of experience in provider relationship management or related healthcare roles • 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 • Strong communication, critical thinking, problem resolution and interpersonal skills • Candidates must reside in Illinois • 10% travel required • Bachelor's degree preferred or a combination of professional work experience and education • Preferred: commercial, individual exchange and Medicare experience • Preferred: experience contracting with hospital systems and groups • Preferred: advanced Excel experience including pivot tables and VLOOKUP

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program • Equity award program • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other well-being resources

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