Senior Manager, Provider Network Strategy

Job not on LinkedIn

🔥 13 hours ago

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

💵 $67.9k - $149.3k / year

⏰ Full Time

🟠 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

• Monitor and manage proactive provider network strategy for the Louisiana Medicaid Market • Ensure compliance with Louisiana Department of Health and NCQA network standards • Monitor monthly progress toward annual network development plan objectives • Provide alternative strategies for at-risk network goals • Conduct market analysis and assess competitive positioning • Recommend strategies for market growth and provider partnerships • Build a prioritized pipeline of provider recruiting targets • Create departmental training materials for identifying appropriate provider targets • Design a network management activity dashboard showing contracting productivity, project status, and escalation requests • Develop and deploy engagement and change strategies to accelerate adoption of processes, tools, and operational practices • Provide real-time recommendations to senior leadership • Partner with matrixed leaders to diagnose organizational challenges and identify solutions

🎯 Requirements

• 7+ years of experience in Medicaid managed care provider contracting, provider engagement, performance management, or value-based contracting • Strong understanding of Medicaid provider environment and reimbursement models • Experience with internal and external stakeholder engagement and partnership • Must live in the Louisiana market • Knowledge of Louisiana Medicaid landscape • Solution-driven approach to provider challenges • Change-enablement strategies and execution experience • Adept at business intelligence • Bachelor's degree or equivalent work experience

🏖️ 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