Remote Strategic Provider Contract Negotiation Manager

CVS Health; Kentucky; Hybrid; USD 60,000 - 133,000; Full time

Benefits offered by this job

Bonus program

Comprehensive benefits

Job summary

CVS Health is seeking an experienced Contract Negotiation Specialist to join our remote team. This role conducts negotiation, execution, review, and analysis of contracts with providers, ensuring performance aligns with accessibility, quality, financial, and cost goals.

The position will involve negotiating single case agreements, analyzing forecast changes, and collaborating with physicians and local networks to achieve favorable outcomes while mentoring junior colleagues.

Qualifications

• 5+ years of experience in provider contracting, claims management, or patient management.
• 2+ years of experience in claims operations or a related claims environment.
• 1-2 years of experience with ACAS and HRP claims platforms, products, and benefits.

Responsibilities

• Negotiate single case agreements for episodes of care on a pre-service basis.
• Analyze forecast changes and develop business impact assessments with process improvement methods.
• Manage cost issues and support cost-saving initiatives and settlements.

Skills

Provider contracting

Claims management

Patient management

Education

Bachelor's degree preferred

Tools

Smart Front End

ASD

HRP

MedCompass

RUMBA applications

Job description

CVS Health is seeking an experienced Contract Negotiation Specialist to join our remote team. This role conducts negotiation, execution, review, and analysis of contracts with providers, ensuring performance aligns with accessibility, quality, financial, and cost goals.

The position will involve negotiating single case agreements, analyzing forecast changes, and collaborating with physicians and local networks to achieve favorable outcomes while mentoring junior colleagues.