Contract Negotiation Manager

Job not on LinkedIn

🕒 June 19

🏛️ District of Columbia, New Jersey, +3 more states – Remote

🏛️ District of Columbia – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🦀 Maryland – Remote 🔔 Pennsylvania – Remote

💵 $66.3k - $145.9k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 39%

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, and conduct high-level review and analysis of dispute resolution and settlement negotiations for complex provider contracts • Recruit providers to support network expansion goals and regulatory or internal adequacy targets • Support health plan expansion initiatives and other contracting activities • Coordinate and own contracting activities through fulfillment, including contract and documentation processing and pre- and post-signature review • Review and modify contract language according to Aetna policies • Audit, build, and load contracts, agreements, amendments, and fee schedules in contract management systems • Collaborate cross-functionally on provider compensation and pricing development, contractual information submission, and reimbursement modeling analysis • Provide subject matter expertise on recruitment initiatives, contracting, provider issues and resolutions, systems, and related information • Apply understanding of value-based contracting and negotiations • Prepare reports and present findings to Network Management leadership • Engage providers and accelerate contracting processes to meet network adequacy standards

🎯 Requirements

• 5+ years of healthcare experience in network contracting and provider relationship management • 3-5 years of negotiating and complex decision-making experience while executing national, regional, or market-level strategies • Knowledge of the managed care industry, including reimbursement models, regulatory requirements, and contracting best practices • Working knowledge of behavioral health topics related to managed care plans • Advanced proficiency in Microsoft Office Suite, particularly Excel and PowerPoint • Ability to build and maintain collaborative provider relationships and partner cross-functionally to resolve complex contract or network issues • Candidates must reside in PA, DE, NY, NJ, MD, or Washington, DC • Bachelor's degree or equivalent professional work experience

🏖️ 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