Senior Manager, Value-Based Care Contracting (Louisiana)

4062 Aetna Resources, LLC; Louisiana (MO); Hybrid; USD 68,000 - 149,000; Full time

Benefits offered by this job

Comprehensive benefits package

Bonus potential

Equity award program

Job summary

CVS Health is seeking a Senior Manager of Network Management to advance the Louisiana Medicaid Market’s value-based contracting strategy. You’ll lead provider relationships, negotiate contracts, set reimbursement terms, and develop performance metrics.

Work with medical leadership, operations and finance to optimize network performance, expand hospital, physician and ancillary networks, and ensure regulatory compliance.

Qualifications

• Minimum 7 years of experience in provider network management, contract negotiations, or value-based contracting within Medicaid or managed care programs.
• Strong understanding of Medicaid reimbursement models, value-based care, and risk sharing arrangements.
• Demonstrated ability to analyze financial and quality performance data and implement process improvements.
• Experience with provider performance measurement, quality improvement and building strong provider partnerships.

Responsibilities

• Directs groups to manage provider contract performance and supports development of strategic, value-based contracts.
• Develops and expands the network by identifying and contracting with hospitals, physicians, specialists, and ancillary providers.
• Interfaces with finance on budgeting, cost analysis, and financial forecasting to manage the financial aspects of network management.
• Consults with internal teams to align network performance goals and objectives and guides leadership decisions.

Skills

Provider network management

Contract negotiations

Value-based contracting

Medicaid experience

Data analysis

Quality improvement

Stakeholder management

Education

Bachelor’s degree preferred

Job description

Company Overview

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

The Senior Manager of Network Management is a critical role in advancing the organization’s Value-Based Contracting (VBC) strategy for the Louisiana Medicaid Market. This position is essential to developing and managing provider relationships that drive improved health outcomes, cost efficiency, and compliance with state and federal Medicaid obligations. Directs groups to manage provider contract performance and supports the development and implementation of strategic, value-based contract relationships. Applies highly developed knowledge to negotiate Network contracts with healthcare providers, establish reimbursement rates, service agreements, and performance metrics. Advises on provider performance, network adequacy, geographical coverage, and member satisfaction, and makes necessary network modifications or expansions. Implement improvement initiatives to ensure that network providers meet all applicable regulatory and quality standards. Develops and expands the network, identifying and contracting with healthcare providers, including hospitals, physicians, specialists, and ancillary service providers. Conducts market analysis, assesses competitive positioning, and recommends strategies to maintain a competitive edge. Interfaces with the finance team on budgeting, cost analysis, and financial forecasting, to manage the financial aspects of provider network management. Consults with internal teams, including medical directors, operations managers, and network development professionals, to align provider network performance goals and objectives. Provides continuous recommendations to senior leadership to guide decision-making and ensure close alignment with the organization's strategic goals and objectives.

Required Qualifications

Minimum 7 years of experience in provider network management, contract negotiations, or value-based contracting within Medicaid or managed care programs. Strong understanding of Medicaid reimbursement models, value-based care, and risk sharing arrangements. Demonstrated ability to analyze financial and quality performance data and implement process improvements. Experience with provider performance measurement, quality improvement and building strong provider partnerships. Reside in the Louisiana market.

Preferred Qualifications

Adept at problem solving and decision-making skills
Adept at collaboration and teamwork
Adept at growth mindset (agility and developing yourself and others) skills
Adept at execution and delivery (planning, delivering, and supporting) skills
Adept at business intelligence

Education

Bachelor’s degree preferred/specialized training/relevant professional qualification.

Pay Range

The typical pay range for this role is: $67,900.00 - $149,328.00 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.

Work Experience & Company Culture

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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 11/28/2026

Additional Information

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.