Contract Negotiation Manager

Job not on LinkedIn

🔥 6 minutes ago

🦌 Connecticut, Florida, +5 more states – Remote

🦌 Connecticut – Remote 🐊 Florida – Remote 🌲 North Carolina – Remote 🏈 Ohio – Remote 🔔 Pennsylvania – Remote 🌴 South Carolina – Remote 🤠 Texas – Remote

💵 $54.3k - $119.3k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CVS Health

WebsiteLinkedInAll Job Openings

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.

📋 Description

• Negotiate, execute, review, and analyze contracts with solo, small-group, local, and other provider partners • 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 cross-functionally on provider compensation and pricing development, contractual information, reimbursement modeling, and report analysis • Identify and recommend ways to manage cost issues and support cost-saving initiatives and settlement activities • Provide network development, maintenance, and refinement strategies for cross-market network management • Assist with designing, developing, managing, and implementing strategic network configurations and integration activities • Optimize interactions with assigned providers and internal business partners to manage relationships and meet provider needs • Resolve escalated issues involving claims payment, contract interpretation and parameters, and provider contract or demographic information accuracy

🎯 Requirements

• Minimum 5 years of experience negotiating contracts with ancillary providers, facilities, and physician groups • Experience with contract language, development and analysis of rate proposals, operational and financial improvement opportunities, 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 • Working knowledge of Aetna systems and tools, including Smart Front End, ASD, HRP, MedCompass, and RUMBA applications, or comparable applications preferred • Candidates located in Pennsylvania, Ohio, Connecticut, Delaware, North Carolina, South Carolina, Florida, Georgia, and Texas are 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