Provider Contracting & Network Management Manager

CVS Health; Louisiana (MO); Hybrid; USD 54,000 - 159,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a contract negotiation professional responsible for constructing negotiation, execution, review, and analysis of contracts with providers. The role includes dispute resolution and ensuring contract performance aligns with accessibility, compliance, quality, financial, and cost goals.

The position emphasizes building relationships with physicians/providers, cross-market network management, and developing cost-saving settlement strategies.

Qualifications

• Bachelor's degree preferred or a combination of professional work experience and education.
• 5+ years of provider contracting, claims management, or patient management experience.

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 with process improvement methods.
• Integrates cross-functional collaboration to support provider compensation and pricing development and negotiation modeling.
• Assists in management of network development, maintenance, and refinement activities and strategies.
• Coaches junior colleagues in techniques, processes, and responsibilities.

Skills

Provider contracting

Claims management

ACAS/HRP platforms

Education

Bachelor's degree

Tools

SCM

Smart Front End

Rate Inquiry

Contract Inquiry

Job description

CVS Health is seeking a contract negotiation professional responsible for constructing negotiation, execution, review, and analysis of contracts with providers. The role includes dispute resolution and ensuring contract performance aligns with accessibility, compliance, quality, financial, and cost goals.

The position emphasizes building relationships with physicians/providers, cross-market network management, and developing cost-saving settlement strategies.