Contract Negotiation Manager

Job not on LinkedIn

🕒 June 10

🏈 Ohio, Pennsylvania, +2 more states – Remote

🏈 Ohio – Remote 🔔 Pennsylvania – Remote ⚔️ Virginia – Remote ⛰️ West Virginia – Remote

💵 $60.3k - $132.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 45%

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, or local providers • Handle dispute resolution and settlement negotiations • Manage contract performance to support network quality, availability, 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 report review and analysis • Identify and recommend solutions for cost issues and support cost-saving initiatives and settlement activities • Perform network development, maintenance, and refinement activities for cross-market network management • Assist with strategic network configuration design, development, management, implementation, and integration • Optimize interactions with assigned providers and internal business partners • Resolve escalated issues involving claims payment, contract interpretation, contract parameters, and provider contract or demographic information accuracy

🎯 Requirements

• Minimum 5 years of experience negotiating contracts with ancillary providers, facilities, and physician groups • 3+ years of experience in provider relationship management or related healthcare roles • Proven and 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 • Highly organized and able to manage and prioritize multiple negotiations, issues, and tasks • Experience with Commercial and Medicare lines of business preferred • Candidates located in Pennsylvania, Ohio, West Virginia, and Delaware strongly 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 range • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being