Senior Manager, Network Contracting

Job not on LinkedIn

🔥 0 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $82.9k - $182.5k / year

⏰ Full Time

🟠 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, conduct high-level review and analysis, and resolve disputes or conduct settlement negotiations for contracts • Manage larger and more complex market, regional, and national provider groups and systems • Contract and implement fee-for-service and value-based agreements with physician groups, facilities, and ancillary providers • Collaborate with Aetna and CVS departments to improve physician performance and quality of care • Recruit providers to achieve network expansion and adequacy targets • Manage cost arrangements within defined provider groups • Partner cross-functionally on provider compensation, pricing development, contractual information submission, and reimbursement modeling • Lead end-to-end contract negotiations, execution, and analysis • Manage contract performance and develop and implement value-based arrangements • Identify, recruit, and onboard providers • Analyze financial and operational data to identify cost-saving opportunities and execute impact-driving initiatives • Represent the organization with providers, customers, and community stakeholders • Evaluate and contribute to provider network strategy aligned with state requirements, product needs, and cost management objectives • Optimize provider engagement and resolve complex escalations involving claims, contract interpretation, and provider data accuracy

🎯 Requirements

• 7+ years of experience negotiating contracts with hospitals, facilities, and physician groups • Experience with contract language development, rate proposal analysis, and identifying operational and financial improvement opportunities • Ability to leverage competitive market data, financial metrics, and detailed analysis to secure favorable contract outcomes • 3+ years of experience in provider relationship management or related healthcare roles • Proven contract management expertise • Working knowledge of provider financial issues and competitor strategies • Knowledge of large/complex contracting options, financial/contracting arrangements, and regulatory requirements • Strong communication, critical thinking, problem resolution and interpersonal skills • Candidates must reside in the state of Illinois • 10% travel required • Advanced Excel experience, including pivot tables and v-lookup function • Commercial, individual exchange and Medicare experience preferred • Experience contracting with hospital systems and groups 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 • Comprehensive benefits package supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program • Award target in the company’s equity award program