Network Contracts & Negotiations Lead

CVS Health; Washington (District of Columbia); Hybrid; USD 54,000 - 159,000; Full time

Benefits offered by this job

Comprehensive benefits

Paid time off

Medical/dental/vision

Retirement options

Bonus program

Job summary

CVS Health in Washington, DC seeks a seasoned Contract Negotiations professional to craft, execute, and review contracts with providers. You will help ensure accessibility, quality, and cost goals while aligning with financial targets.

This full-time role offers a base pay range of $54,300 to $159,120 and a comprehensive benefits package including medical, dental, and vision coverage, retirement options, and paid time off. Experience with ACAS/HRP systems and Aetna networks is preferred.

Qualifications

• 5+ years of provider contracting, claims management, or patient management experience.
• 5+ experience working with/or in a Claims environment
• 5+ experience that includes ACAS and HRP claim platforms, products, and benefits; patient management, provider relations, or claims management.

Responsibilities

• Develop, maintain, and enhance working relationships with physicians/providers and local network and patient management teams in the markets with Aetna.
• Establishes and implements programs and innovative initiatives for the organization to advance Contract Negotiations initiatives.
• Forecasts changes within the Contract Negotiations industry, conducts business impact assessments, and develops modification strategies with the aid of process improvement methodologies.
• Integrates cross-functional collaboration to contribute to provider compensation and pricing development activities and recommendations for negotiations and reimbursement modeling activities.
• Determines recommendations to manage cost issues and support cost-saving initiatives and settlement activities.
• Assists in the management of network development, maintenance, and refinement activities and strategies in support of cross-market network management units.

Skills

Provider contracting

Contract negotiations

Claims management

ACAS/HRP platforms

Budgeting/cost modeling

Cross-functional collaboration

Education

Bachelor's degree

Job description

CVS Health in Washington, DC seeks a seasoned Contract Negotiations professional to craft, execute, and review contracts with providers. You will help ensure accessibility, quality, and cost goals while aligning with financial targets.

This full-time role offers a base pay range of $54,300 to $159,120 and a comprehensive benefits package including medical, dental, and vision coverage, retirement options, and paid time off. Experience with ACAS/HRP systems and Aetna networks is preferred.