Senior Manager, Network Management, National Behavioral Health

Hispanic Alliance for Career Enhancement; New York (NY); On-site; USD 67,000 - 183,000; Full time

Job summary

An established industry player is seeking a Network Management Senior Manager to lead negotiations and manage contracts with behavioral health providers. This pivotal role requires strong negotiation skills and the ability to drive strategic partnerships. As part of a dynamic team, you'll work to enhance healthcare delivery and ensure effective provider relationships. You'll play a crucial role in optimizing network performance and implementing value-based contracts that align with business strategies. Join a forward-thinking organization dedicated to transforming healthcare and making a significant impact in the lives of many.

Benefits

401(k) Plan with Matching Contributions

Employee Stock Purchase Plan

Wellness Screenings

Tobacco Cessation Programs

Weight Management Programs

Confidential Counseling

Financial Coaching

Paid Time Off

Flexible Work Schedules

Tuition Assistance

Qualifications

• 5+ years of managed care network negotiating experience.
• Knowledge of commercial, Medicare, and Medicaid systems.

Responsibilities

• Manage negotiations and contract performance for behavioral health providers.
• Collaborate cross-functionally to optimize provider compensation.

Skills

Managed Care Network Negotiation

Communication Skills

Critical Thinking

Problem Resolution

Interpersonal Skills

Business Intelligence

Presentation Skills

Collaboration

Growth Mindset

Education

Bachelor's Degree

Job description

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

Do you want to make a large impact in your next role? Join Aetna/CVS Health, a Fortune 4 company, as the Network Management Senior Manager. In this role, you will manage negotiations, conduct high-level reviews and analysis, and manage dispute resolution and settlement negotiations of contracts, with large and complex, national, and market-based, behavioral health groups and facility providers. You will manage contract performance and support the development and implementation of strategic, traditional contracts and value-based relationships.

**Role is for national behavioral health contracting and strategic partnerships

Key deliverables in this role include:

• Recruit large scale and/or innovative providers as needed to ensure attainment of network expansion and strategic targets.
• Collaborate cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities.
• Responsible for identifying and managing cost issues and initiating appropriate cost saving initiatives and settlement activities.
• Assist with the design, development, management, and or implementation of strategic network configurations and integration activities.
• Manage contract performance and drive the development and implementation of value-based contract relationships in support of business strategies.
• Represent Aetna with high visibility constituents, including customers and community groups. Promote collaboration with internal partners.
• Evaluate, formulate, and implement the provider network strategic plan to achieve contracting targets and manage medical costs through effective provider contracting.
• Optimize interaction with assigned providers and internal business partners to facilitate relationships and ensure provider needs are met.

To be successful, you will utilize your strong communication, critical thinking, problem resolution and interpersonal skills.

Additional Skills:
• Adept at execution and delivery (planning, delivering, and supporting) skills

• Adept at business intelligence

• Adept presentation skills
• Adept at collaboration and teamwork
• Adept at growth mindset (agility and developing yourself and others) skills

Required Qualifications

• Commercial, Medicare, and/or Medicaid knowledge

• 5+ years related experience, proven and proficient managed care network negotiating skills.

• 3+ years contracting for large facilities or provider groups.

• Proven working knowledge of competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements.

Preferred Qualifications

• Proven working knowledge of value based (VBC) and Pay for Performance (P4P) behavioral health contracting solutions.

• Experience with behavioral health Institutes of Quality (IOQ).
• Well versed with the behavioral health provider national market.

Education

• Bachelor's degree preferred/specialized training/relevant professional qualification.

Pay Range

The typical pay range for this role is:

$67,900.00 - $182,549.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company's equity award program.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 06/06/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.