Strategic Network Contracts Manager – Health Systems

CVS Health; Wyoming; Hybrid; USD 54,000 - 159,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a skilled Contract Negotiations professional responsible for constructing negotiation, execution, review, and analysis of contracts with providers to ensure alignment with accessibility, quality, financial, and cost goals. The role involves building relationships with physicians and local networks, implementing innovative programs, and guiding cost-saving initiatives.

Experience in ACAS/HRP platforms is preferred.

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.

Skills

Negotiation

Contract management

Provider relations

Claims management

Education

Bachelor's degree

Tools

ACAS

HRP

SCM

Smart Front End

Rate Inquiry

Contract Inquiry

Job description

CVS Health is seeking a skilled Contract Negotiations professional responsible for constructing negotiation, execution, review, and analysis of contracts with providers to ensure alignment with accessibility, quality, financial, and cost goals. The role involves building relationships with physicians and local networks, implementing innovative programs, and guiding cost-saving initiatives.

Experience in ACAS/HRP platforms is preferred.