Senior Network Contracting Negotiation Manager

Job not on LinkedIn

🕒 August 7

🚗 Michigan – Remote

🚗 Michigan – Remote

💵 $75.4k - $166k / year

⏰ Full Time

🟠 Senior

👔 Manager

👻 Ghost score 23%

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 complex network contracts with healthcare providers • Establish 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, network development professionals, and other internal teams • Align provider network performance goals and objectives • Provide recommendations to senior leadership to guide decision-making and align with strategic goals

🎯 Requirements

• 7+ years healthcare industry experience • 5+ years 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/Excel proficiency • Ability to travel in assigned market up to 10-15% of the time as needed (Michigan) • 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 • Bachelor’s Degree or equivalent professional 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