Provider Contract Negotiation Manager
CVS Health
full-time
Posted on:
Location Type: Remote
Location: Idaho • Missouri • United States
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Salary
💰 $54,300 - $145,860 per year
About the role
- Constructs negotiation, execution, review, and analysis of contracts.
- Delivers dispute resolution and settlement negotiations with providers.
- Ensures contract performance aligns with accessibility, compliance, quality, financial, and cost goals.
- Negotiate single case agreements for episodes of care on a pre-service basis.
- Participation/engagement in looking at forecasts changes within the Contract Negotiations industry, development of business impact assessments, and modification strategies with the aid of process improvement methodologies.
- Determines recommendations to manage cost issues and support cost-saving initiatives and settlement activities.
- Develop, maintain, and enhance working relationships with physicians/providers and local network and patient management teams in the markets within Aetna.
- Coaches more junior colleagues in techniques, processes, and responsibilities.
Requirements
- 2+ years of experience in provider contracting, claims management or patient management.
- 2+ years’ experience working with/or in a Claims environment.
- 1-2 years’ experience that includes ACAS and HRP claim platforms, products, and benefits; patient management; provider relations or claims management.
- Knowledge/experience with National Advantage Program within Aetna (preferred).
- Aetna systems (Smart Front End, ASD, ATV, HRP, MedCompass. RUMBA – EPDB, EWMP, Rate Inquiry, Contract Inquiry) (preferred).
- Bachelor's Degree or equivalent years of experience.
Benefits
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Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
contract negotiationdispute resolutioncost managementbusiness impact assessmentprocess improvement methodologiesclaims managementprovider contractingpatient management
Soft Skills
relationship buildingcoachingcommunication