Senior Manager, Contract Negotiation
CVS Health
full-time
Posted on:
Location Type: Remote
Location: Illinois • Kansas • United States
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Salary
💰 $67,900 - $165,954 per year
Job Level
About the role
- Supports Provider Contracting and Relationship Management for the Commercial and Medicare Segments with large and small health systems
- Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with providers
- Manages contract performance in support of network quality, availability, and financial goals and strategies
- Recruit providers as needed to ensure attainment of network expansion and adequacy targets
- Collaborates cross-functionally to contribute to provider compensation and pricing development activities, recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities
- Integrates cross-functional collaboration to contribute to provider compensation and pricing development activities and recommendations for negotiations and reimbursement modeling activities
- Identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities
- Provides ancillary network development, maintenance, and refinement activities and strategies in support of cross-market network management unit
- Assists with the design, development, management, and/or implementation of strategic network configurations, including integration activities
- Optimizes interaction with assigned providers and internal business partners to manage relationships and ensure providers needs are met
- Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation, and parameters or accuracy of provider contract or demographic information
- Coaches more junior colleagues in techniques, processes, and responsibilities.
Requirements
- 7+ years of Healthcare industry experience
- 5+ years of Provider Contract Network and Negotiation experience preferably
- Proven working knowledge of competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements
- 3+ years related experience Commercial HMO, PPO products knowledge
- 3+ years related experience Medicare and/or Medicaid products knowledge
- Intermediate knowledge of Microsoft Office, specifically Excel and PowerPoint
- A ready business acumen and the ability to balance and articulate competing priorities while making decisions
- Strong and persuasive communication skills, especially written communications, with external stakeholders
- Strong critical thinking, problem resolution and interpersonal skills
- Adept at execution and delivery (planning, delivering, and supporting) skills
- Adept at collaboration and teamwork
- A growth mindset (agility and developing yourself and others) skills.
Benefits
- medical, dental, and vision coverage
- paid time off
- retirement savings options
- wellness programs
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
provider contractingnegotiationcontract analysiscost managementnetwork developmentstrategic network configurationsreimbursement modelingfinancial arrangementsregulatory requirementsHMO products knowledge
Soft Skills
communication skillscritical thinkingproblem resolutioninterpersonal skillscollaborationteamworkbusiness acumendecision makingcoachinggrowth mindset