Remote Medicaid Contract Negotiations Manager

CVS Health Corporation; United States; Hybrid; USD 54,000 - 119,000; Full time

Job summary

CVS Health is seeking a Manager, Contract Negotiations for Louisiana Medicaid in a work-from-home hybrid role. You will recruit, negotiate and execute provider contracts to expand the Louisiana Medicaid network and optimize interactions with providers and internal partners.

The role requires 3–5 years of managed care contracting experience, strong knowledge of reimbursement methodologies, and the ability to travel up to 15%. A Bachelor’s degree or equivalent is required.

Qualifications

• 3-5 years of experience negotiating managed care provider contracts
• In-depth knowledge of the managed care industry and reimbursement methodologies
• Strong communication, critical thinking, problem resolution and interpersonal skills
• MS Office Suite proficiency
• Ability to travel up to 15% of the time
• Residence in Louisiana; Hybrid (in Baton Rouge office 1-2x/mo)

Responsibilities

• Recruit, negotiate and execute provider contracts to expand Louisiana Medicaid network.
• Optimize interaction with providers and internal partners to meet provider needs.
• Identify and manage cost issues and initiate cost-saving initiatives or settlements.
• Assist with design, development, management, and implementation of strategic network configurations and integration activities.
• Resolve escalated issues related to claims payment, contract interpretation, or data accuracy.
• Manage complex provider relationships to support national and regional network strategies.
• Collaborate cross-functionally on hospital, ancillary and provider compensation and pricing development, including reporting and reimbursement modeling.

Skills

Contract negotiation

Communication

Problem solving

Interpersonal skills

MS Office

Education

Bachelor’s degree

Tools

MS Office Suite

Job description

CVS Health is seeking a Manager, Contract Negotiations for Louisiana Medicaid in a work-from-home hybrid role. You will recruit, negotiate and execute provider contracts to expand the Louisiana Medicaid network and optimize interactions with providers and internal partners.

The role requires 3–5 years of managed care contracting experience, strong knowledge of reimbursement methodologies, and the ability to travel up to 15%. A Bachelor’s degree or equivalent is required.