Senior Network Contracts & Negotiations Manager

4062 Aetna Resources, LLC; United States; On-site; USD 54,000 - 159,000; Full time

Job summary

CVS Health is seeking a Contract Negotiator to construct negotiation, execution, review, and analysis of contracts. Delivers dispute resolution and settlement negotiations with providers, ensuring contract performance aligns with accessibility, quality, financial, and cost goals.

You will develop, maintain, and enhance relationships with physicians/providers and local network teams in markets with Aetna. You will forecast changes in contract negotiations, conduct impact assessments, and

Qualifications

• 5+ years of provider contracting, claims management, or patient management experience.
• 5+ experience working with/or in a Claims environment
• 5+ experience that includes 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 network and patient management teams in the markets with Aetna.
• Establishes and implements programs and innovative initiatives for the organization to advance Contract Negotiations initiatives.
• Forecasts changes within the Contract Negotiations industry, conducts business impact assessments, and develops modification strategies with the aid of process improvement methodologies.
• Integrates cross-functional collaboration to contribute to provider compensation and pricing development activities and recommendations for negotiations and reimbursement modeling activities.
• Determines recommendations to manage cost issues and support cost-saving initiatives and settlement activities.
• Assists in the management of network development, maintenance, and refinement activities and strategies in support of cross-market network management units.
• Coaches more junior colleagues in techniques, processes, and responsibilities.
• Other duties and responsibilities as assigned by manager.

Skills

Provider contracting experience

Claims environment experience

ACAS and HRP platforms experience

Education

Bachelor's degree preferred

Tools

ACAS

HRP

SCM

Smart Front End

Rate Inquiry

Contract Inquiry

Job description

CVS Health is seeking a Contract Negotiator to construct negotiation, execution, review, and analysis of contracts. Delivers dispute resolution and settlement negotiations with providers, ensuring contract performance aligns with accessibility, quality, financial, and cost goals.

You will develop, maintain, and enhance relationships with physicians/providers and local network teams in markets with Aetna. You will forecast changes in contract negotiations, conduct impact assessments, and