Lead Director, Network Management

Job not on LinkedIn

🔥 13 hours ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $100k - $231.5k / year

⏰ Full Time

🟠 Senior

👔 Director

👻 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

• Design conceptual models and plan initiatives • Negotiate Commercial/Medicare Advantage agreements with Texas providers, including health systems, clinically integrated networks, IPAs, FQHCs and others • Maintain and enhance Commercial/Medicare Advantage provider networks • Work cross-functionally to ensure consistency with contracting strategies • Meet and exceed accessibility, quality, compliance, regulatory, financial, and cost initiative goals

🎯 Requirements

• 10+ years related experience • Expert-level negotiation skills with a successful track record negotiating contracts with large or complex national vendors/providers • Working knowledge of provider financial issues and competitor strategies • Knowledge of complex contracting options, financial/contracting arrangements, and regulatory requirements • Ability to identify and manage initiatives that improve total medical cost and quality • Health Plan/Payer or Provider Systems experience • Must reside in Texas • Bachelor's degree or equivalent professional work experience • Preferred: Commercial/Medicare Advantage Fee-for-Service contract experience • Preferred: Commercial/Medicare Advantage regulatory experience • Preferred: Commercial/Medicare Advantage contracting and setup experience • Preferred: Working knowledge of Value-Based Contracting

🏖️ 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 • Equity award program