Senior Network Contracts Manager - Health Systems

CVS Health; Washington (District of Columbia); Hybrid; USD 54,000 - 159,000; Full time

Benefits offered by this job

Comprehensive benefits package

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health in Washington, DC is seeking an experienced contract professional to construct negotiation, execution, review, and analysis of contracts with providers and to support dispute resolution and settlement negotiations.

The role focuses on improving accessibility, quality, and cost goals, building relationships with physicians/providers, and guiding cross-functional teams in reimbursement modeling and cost-saving initiatives.

Qualifications

• 5+ years of provider contracting, claims management, or patient management experience.
• 5+ experience in a Claims environment.
• 5+ experience with ACAS and HRP claim platforms, products, and benefits; patient management, provider relations, or claims management.

Responsibilities

• Develop, maintain, and enhance working relationships with physicians/providers and local networks.
• Establish programs and initiatives for Contract Negotiations.
• Forecast changes in the Contract Negotiations industry and assess business impact.
• Integrate cross-functional collaboration for provider compensation and pricing development.
• Recommend strategies to manage costs and settlement activities.
• Assist in network development, maintenance, and refinement activities.
• Coach junior colleagues in techniques and processes.
• Perform other duties as assigned by manager.

Skills

Provider contracting

Claims management

Patient management

Education

Bachelor's degree preferred

Tools

ACAS

HRP claim platforms

Job description

CVS Health in Washington, DC is seeking an experienced contract professional to construct negotiation, execution, review, and analysis of contracts with providers and to support dispute resolution and settlement negotiations.

The role focuses on improving accessibility, quality, and cost goals, building relationships with physicians/providers, and guiding cross-functional teams in reimbursement modeling and cost-saving initiatives.