Strategic Network Contracts Manager – Health Systems

CVS Health; New Jersey; Hybrid; USD 54.000 - 159.000; Vollzeit

Benefits dieser Stelle

Medical, dental, vision coverage

Paid time off

Retirement savings options

Wellness programs

Zusammenfassung

CVS Health in New Jersey is seeking an experienced contracts professional to construct negotiation, execution, and review of provider contracts. You will deliver dispute resolution and ensure contract performance aligns with accessibility, quality, financial, and cost goals.

Develop and maintain relationships with physicians/providers and local network teams, drive innovative initiatives in contract negotiations, and mentor junior colleagues.

Qualifikationen

• 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.

Aufgaben

• 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.

Kenntnisse

Provider contracting

Claims management

ACAS/HRP platforms

Ausbildung

Bachelor's degree

Tools

Aetna SCM, Smart Front End, Rate Inquiry, Contract Inquiry

Jobbeschreibung

CVS Health in New Jersey is seeking an experienced contracts professional to construct negotiation, execution, and review of provider contracts. You will deliver dispute resolution and ensure contract performance aligns with accessibility, quality, financial, and cost goals.

Develop and maintain relationships with physicians/providers and local network teams, drive innovative initiatives in contract negotiations, and mentor junior colleagues.