Contract Negotiation Manager

Job not on LinkedIn

🔥 12 hours ago

🌵 Arizona, California, +2 more states – Remote

🌵 Arizona – Remote 🏄 California – Remote 🎰 Nevada – Remote ☕ Washington – Remote

💵 $60.3k - $132.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

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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 and handle dispute resolution and settlement negotiations with solo, small group, or local providers, including SCAs, LOAs, and PPAs • Manage contract performance in support of network quality, availability, and financial goals and strategies • Recruit providers to achieve network expansion and adequacy targets • Collaborate cross-functionally on provider compensation and pricing development, contractual information submission, and negotiation and reimbursement modeling reports • Identify and recommend actions to manage cost issues and support cost-saving initiatives and settlement activities • Provide network development, maintenance, and refinement activities and strategies for cross-market network management • Assist with strategic network configuration design, development, management, implementation, 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 • Interpret contractual requirements, including federal and state regulations and NCQA standards

🎯 Requirements

• 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, including Excel, Word, PowerPoint, and Outlook • Candidates residing on the West Coast are strongly preferred • Bachelor's degree preferred or a combination of professional 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 in addition to base pay