Senior Network Contracting Negotiation Manager

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🔥 0 minutes ago

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $75.4k - $166k / year

⏰ Full Time

🟠 Senior

👔 Manager

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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 complex network contracts with healthcare providers, establishing reimbursement rates, service agreements, and performance metrics • Advise on provider performance, network adequacy, geographical coverage, and member satisfaction • Make necessary network modifications or expansions • Implement improvement initiatives to ensure network providers meet regulatory and quality standards • Develop and expand the network by identifying and contracting with hospitals, physicians, specialists, and ancillary service providers • Conduct market analysis and assess competitive positioning • Recommend strategies to maintain a competitive edge • Interface with finance on budgeting, cost analysis, and financial forecasting • Manage the financial aspects of provider network management • Consult with medical directors, operations managers, and network development professionals to align performance goals • Provide continuous recommendations to senior leadership to guide decision-making and align with strategic goals

🎯 Requirements

• 7+ years of healthcare industry experience • 5+ years of related experience • Comprehensive provider negotiating skills with a successful track record negotiating contracts with complex provider systems or groups • Must reside in Michigan • Critical thinking to maintain cost management and a fully engaged network of participating hospitals, ancillaries, and providers • Microsoft Office and Excel proficiency • Ability to travel in the assigned Michigan market up to 10–15% of the time as needed • Experience using contract management systems preferred • Relevant experience and understanding of the local healthcare market and payer dynamics preferred • Demonstrated analytical aptitude with proven capability to troubleshoot complex issues preferred • Skilled at connecting data to daily execution of tasks preferred • Bachelor’s Degree or equivalent professional work experience

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program • Award target in the company’s equity award program • 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