Manager, Provider Contract Negotiation (Michigan)

CVS Health; Milford (MI); On-site; USD 75,000 - 90,000; Full time

Job summary

CVS Health is seeking a Manager for Provider Contract Negotiation in Michigan. This mid-senior level position involves negotiating contracts with healthcare providers while ensuring network quality and financial goals are met. The ideal candidate will have strong negotiation skills, knowledge of Michigan's healthcare landscape, and a bachelor's degree.

Qualifications

• 3-5 years related experience.
• Proficient in negotiating contracts.
• Knowledge of Michigan healthcare provider markets.

Responsibilities

• Negotiate, execute, review, and analyze contracts with providers.
• Manage contract performance and provider relationships.
• Assist in network management and provider recruitment.

Skills

Negotiating skills

Communication

Critical thinking

Problem resolution

Interpersonal skills

Education

Bachelor's degree

Job description

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Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with solo, small group, or local providers. Manages contract performance in support of network quality, availability, and financial goals and strategies. Recruits providers as needed to ensure attainment of network expansion and adequacy targets. Collaborates cross-functionally to contribute to provider compensation and pricing development activities and recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities. Responsible for identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities. Provides 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. May optimize interaction with assigned providers and internal business partners to manage relationships and ensure provider 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. Required Qualifications: Proven working knowledge of competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements. Must reside in Michigan and be well versed with the Michigan healthcare provider markets. 3-5 years related experience, proven and proficient negotiating skills. Preferred Qualifications: Strong communication, critical thinking, problem resolution and interpersonal skills. Commercial, PPO products knowledge. Medicare experience. Education: Bachelor's degree preferred.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Management and Manufacturing

• Industries

  Hospitals and Health Care

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