Senior Manager, Strategic Planning -Provider Network Management

Rhode Island Bar Assn.; Woonsocket (RI); On-site; USD 67,000 - 183,000; Full time

Job summary

A leading health solutions company seeks a professional to support provider negotiations and financial risk management. The role involves analyzing network performance and collaborating across teams to enhance market performance. Candidates should have extensive analytical experience and strong communication skills, preferably with a Bachelor's degree.

Benefits

Affordable medical plan options

401(k) plan with matching contributions

Employee stock purchase plan

Wellness screenings and counseling programs

Tuition assistance

Qualifications

• 5+ years of analytical experience in network, contracting, pricing, finance and/or market.
• 5+ years Healthcare industry experience.
• Ability to navigate web-based tools.

Responsibilities

• Support network teams in provider negotiations and financial risk.
• Communicate network performance analysis to Market leaders.
• Utilize various data sources to identify market drivers.

Skills

Analytical skills

Communication skills

Proficiency in Microsoft Excel

Education

Bachelor's degree preferred

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

Supports network teams in provider negotiations and financial risk for Commercial, Medicare, Medicaid, and IFP businesses.

• Work directly with network, provides current and relevant data to support provider negotiations.
• Communicate network performance analysis to Market leaders, noting drivers impacting pModel and SAIs (Scoreable Action Initiatives) and potential actions to mitigate costs across multiple Lines of Business.
• Utilize various data sources to identify market drivers and potential opportunities to improve market performance, e.g., HCIC (Health Care Information Center), pModel, SAI Database, QAT, COIN.
• Evaluate contract deviations and contract outliers, drive for improvement in costs to better position Aetna in the marketplace.
• Review and interpret medical transparency data; summarize and communicate potential contracting opportunities to network.

• Leverage colleagues and business partners to identify and resolve issues as they arise.
• Collaborate across the organization to ensure complete projects.

The candidate will have a strong work ethic, be a self-starter, and be able to be highly productive in a dynamic, collaborative environment. This position offers broad exposure to many aspects of the company's business, as well as significant interaction with business leaders.

**The position may sit in any location.

Required Qualifications

• 5+ years of analytical experience in network, contracting, pricing, finance and/or market with proficiency utilizing Microsoft Excel to include pivot tables, VLOOKUP's, and etc.
• Ability to navigate web-based tools to gather information and turn into action.
• 5+ years Healthcare industry experience
• Adept at execution and delivery (planning, delivering, and supporting) skills.
• Strong communication skills in a highly matrixed environment

Education

• Bachelor's degree preferred

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: 06/30/2025

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