
10,000+ employees
Founded 1963
🏥 Healthcare
⚕️ Healthcare Insurance
🛒 Retail
Healthcare • Healthcare Insurance • Retail
CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.
🔥 4 minutes ago
🌵 Arizona, California, +3 more states – Remote
💵 $60.3k - $132.6k / year
⏰ Full Time
🟡 Mid-level
🟠 Senior
👔 Manager
👻 Ghost score 0%
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10,000+ employees
Founded 1963
🏥 Healthcare
⚕️ Healthcare Insurance
🛒 Retail
Healthcare • Healthcare Insurance • Retail
CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.
• Negotiate, execute, review, and analyze contracts and handle dispute resolution and settlement negotiations with providers • Manage contract performance in support of network quality, availability, and financial goals • Recruit providers to achieve network expansion and adequacy targets • Collaborate on provider compensation, pricing development, contractual information, negotiation, and reimbursement modeling activities • Identify cost issues and recommend cost-saving initiatives and settlement activities • Provide network development, maintenance, and refinement strategies for cross-market network management • Assist with strategic network configuration, integration, and implementation activities • Optimize interactions with assigned providers and internal business partners • Resolve escalated issues involving claims payment, contract interpretation, and provider contract or demographic information • Interpret contractual requirements, including federal and state regulations and NCQA
• 5+ years of working knowledge of the healthcare industry, including competitor strategies, complex contracting options, financial and contracting arrangements, and regulatory requirements • 3+ years of experience in provider relationship management or related healthcare roles • Proven and proficient contract management skills • Strong communication, critical thinking, problem-resolution and interpersonal skills • Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook) • Bachelor's degree preferred or a combination of professional work experience and education • Candidates residing on the West Coast are strongly preferred
• 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 in addition to base pay
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