Strategic Provider Contract Negotiator

CVS Health; Ohio; On-site; USD 54,000 - 119,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a contracts professional in Ohio to negotiate agreements with providers, manage contract performance, and expand the network. The role requires deep knowledge of provider reimbursement and experience with Commercial and Medicare lines.

Collaboration across teams is essential to align compensation, rate development, and cost initiatives. The successful candidate will drive cost savings, manage complex negotiations, and ensure data accuracy across the provider network while

Qualifications

• Minimum 5 years of experience negotiating contracts with ancillary providers, facilities, and physician groups.
• 3+ years of experience in provider relationship management or related healthcare roles.
• Understanding of common contract provisions, provider reimbursement methodologies and terms.
• Experience with Commercial and Medicare lines of business.
• Bachelor's degree preferred or combination of work experience and education.

Responsibilities

• Negotiate contracts with providers to meet accessibility, quality, and cost goals.
• Manage contract performance in support of network quality, availability, and financial goals.
• Recruit providers to expand network expansion and adequacy targets.
• Collaborate cross-functionally on provider compensation and rate development activities.
• Identify cost-saving opportunities and support settlements and cost initiatives.
• Provide network development and management strategies in cross-market units.
• Assist with design and implementation of strategic network configurations.
• Ensure resolution of escalated issues related to claims, contract interpretation, and provider data.

Skills

Negotiation

Contract management

Provider relations

Cross-functional teamwork

Financial analysis

Microsoft Office

Education

Bachelor's degree

Tools

Smart Front End

ASD

HRP

MedCompass

RUMBA

Job description

CVS Health is seeking a contracts professional in Ohio to negotiate agreements with providers, manage contract performance, and expand the network. The role requires deep knowledge of provider reimbursement and experience with Commercial and Medicare lines.

Collaboration across teams is essential to align compensation, rate development, and cost initiatives. The successful candidate will drive cost savings, manage complex negotiations, and ensure data accuracy across the provider network while