Federal Sales Account Executive
CACI International Inc
Senior Manager, Provider Contract Network Management
CVS Health
full-time
Posted on:
Origin: • 🇺🇸 United States • Virginia
Visit company websiteSalary
💰 $75,400 - $165,954 per year
Job Level
Senior
About the role
- Negotiates, executes, conducts high level review and analysis, dispute resolution and/or settlement negotiations of contracts with larger and more complex, market-based group/system providers in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals and cost initiatives.
- Analyzes market needs and opportunities for network expansion, identifies gaps in the existing network, and proactively seeks new provider relationships to address those gaps.
- Ensures governance with healthcare regulations and contractual requirements, implementing strategies and processes to adhere to guidelines and requirements.
- Initiates moderate and/or complex contracting activities, including the collection of all required contract and credentialing documents, and obtains the necessary approval of non-standard rates and language modifications to contracts.
- Collaborates on negotiations or may handle contracting and re-contracting discussions with providers, provider groups and/or health systems .
- May participate in various internal and/or external meetings, serving as representative on behalf of the department .
- Supports or assists with operational activities that may include, but are not limited to, database management and contract coordination.
- Provides ongoing recommendations to leadership to guide decision-making and ensure alignment with the organization’s strategic goals.
- Coaches and mentors more junior level colleagues in contracting techniques, processes and responsibilities.
Requirements
- 7+ years related experience and expert level negotiation skills with successful track record negotiating contracts with large or complex provider systems.
- Strong communication, critical thinking, problem resolution and interpersonal skills.
- Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, financial/contracting arrangements and regulatory requirements.
- Medicaid Network Management experience.
- Reside within the Commonwealth of Virginia.
- Education Bachelor's Degree preferred or relevant professional experience.
