Provider Contract Negotiations Manager

CVS Health; Missouri; Hybrid; USD 54,000 - 159,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking an experienced Contracts Specialist in Missouri to construct negotiation, execution, review, and analysis of contracts. You will deliver dispute resolution with providers and ensure contract performance aligns with accessibility, quality, financial, and cost goals.

Responsibilities include managing relationships with physicians/providers, developing negotiation programs, and mentoring junior colleagues while collaborating across networks to optimize reimbursement models and

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.
• Establishes and implements programs and innovative initiatives for the organization to advance Contract Negotiations initiatives.
• Forecasts changes within the Contract Negotiations industry and develops modification strategies.
• Integrates cross-functional collaboration to contribute to provider compensation and pricing development activities.
• Determines recommendations to manage cost issues and support cost-saving initiatives and settlement activities.
• Coaches more junior colleagues in techniques, processes, and responsibilities.

Skills

Provider contracting

Claims management

Patient management

Education

Bachelor's degree preferred

Tools

SCM

Smart Front End

Rate Inquiry

Contract Inquiry

Job description

CVS Health is seeking an experienced Contracts Specialist in Missouri to construct negotiation, execution, review, and analysis of contracts. You will deliver dispute resolution with providers and ensure contract performance aligns with accessibility, quality, financial, and cost goals.

Responsibilities include managing relationships with physicians/providers, developing negotiation programs, and mentoring junior colleagues while collaborating across networks to optimize reimbursement models and