Provider Contract & Network Negotiations Manager

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

Benefits offered by this job

Medical, Dental, Vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health in the United States is seeking a senior contract negotiations professional to construct negotiation, execution, review, and analysis of contracts. You will deliver dispute resolution and settlement negotiations with providers while ensuring alignment with accessibility, quality and cost goals.

The role involves cross-functional collaboration with physicians, network teams, and patient management to advance contracting initiatives, forecast industry changes, and support cost-saving

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

• Constructs negotiation, execution, review, and analysis of contracts.
• Delivers dispute resolution and settlement negotiations with providers.
• Forecasts changes within the Contract Negotiations industry, conducts business impact assessments and develops modification strategies.
• 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.
• Coaches more junior colleagues in techniques, processes, and responsibilities.

Skills

Negotiation

Contract analysis

Dispute resolution

Education

Bachelor's degree

Tools

SCM

Smart Front End

Rate Inquiry

Contract Inquiry

Job description

CVS Health in the United States is seeking a senior contract negotiations professional to construct negotiation, execution, review, and analysis of contracts. You will deliver dispute resolution and settlement negotiations with providers while ensuring alignment with accessibility, quality and cost goals.

The role involves cross-functional collaboration with physicians, network teams, and patient management to advance contracting initiatives, forecast industry changes, and support cost-saving