Healthcare Network Partnerships Manager

CVS Health Corporation; Raleigh (NC); On-site; USD 54,000 - 146,000; Full time

Job summary

CVS Health Corporation in Raleigh, NC seeks an experienced healthcare provider relationships professional to design, manage, and optimize a contractual network of providers serving members. The role emphasizes evaluating performance, resolving disputes, and expanding the network in collaboration with internal stakeholders.

You will analyze provider performance, negotiate terms with providers, and work with finance, operations, and customer service teams to ensure alignment with strategic goals.

Qualifications

• 5+ years in healthcare provider relationship management with complex networks.
• Ability to resolve disputes and identify growth opportunities.
• Strong communication and stakeholder management skills.
• Proficiency with Excel to analyze provider data.
• Willingness to travel up to 10%.

Responsibilities

• Establishes relationships with network providers, fostering open communication and collaboration to ensure a strong network partnership.
• Analyzes network provider performance and quality indicators, conducting regular assessments and audits to ensure compliance with contractual obligations and service level agreements.
• Addresses and resolves escalated issues and concerns raised by network providers, demonstrating a proactive and customer-centric approach to problem-solving.
• Collaborates with network contracting teams to negotiate and establish contractual terms and conditions with network providers, ensuring alignment with organizational goals and objectives.
• Develops tactical and operational plans to expand and enhance the network, working closely with business development teams to identify and onboard new providers in strategic areas.
• Monitors and analyzes network data, including provider demographics and network adequacy metrics, to assess the effectiveness and efficiency of the network and make recommendations for improvements.
• Collaborates with cross-functional teams, such as finance, operations, and customer service, to ensure effective coordination and alignment of network-related activities and initiatives.
• Conducts regular meetings with network providers to review performance metrics, address concerns, and identify opportunities for improvement.
• Stays updated on industry trends, regulatory changes, and market dynamics that may impact network provider relationships, and proactively communicates relevant information to internal stakeholders.

Skills

Provider relationship mgmt

Cross-functional collaboration

Critical thinking

Problem solving

Communication

Travel up to 10%

MS Office proficiency

Education

Bachelor's degree or higher in related field

Tools

Microsoft Excel

Outlook

Job description

CVS Health Corporation in Raleigh, NC seeks an experienced healthcare provider relationships professional to design, manage, and optimize a contractual network of providers serving members. The role emphasizes evaluating performance, resolving disputes, and expanding the network in collaboration with internal stakeholders.

You will analyze provider performance, negotiate terms with providers, and work with finance, operations, and customer service teams to ensure alignment with strategic goals.