Strategic Provider Contract & Network Manager

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

Benefits offered by this job

Bonus eligibility

Benefits package

Job summary

CVS Health in the United States is seeking a seasoned professional to construct, negotiate, and review provider contracts. You will deliver dispute resolution and settlement negotiations with providers, ensuring contract performance aligns with accessibility, quality, and cost goals.

You will cultivate relationships with physicians and providers, support cost-saving initiatives, and mentor junior colleagues while collaborating across cross-functional teams.

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.
• Establishes and implements programs and innovative initiatives for the organization to advance Contract Negotiations initiatives.
• Forecasts changes within the Contract Negotiations industry and develops modification strategies.
• Integrates cross-functional collaboration to contribute to provider compensation and pricing development 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.
• Coaches more junior colleagues in techniques, processes, and responsibilities.

Skills

Provider contracting

Claims management

Patient management

Education

Bachelor's degree preferred

Tools

ACAS

HRP claim platforms

Job description

CVS Health in the United States is seeking a seasoned professional to construct, negotiate, and review provider contracts. You will deliver dispute resolution and settlement negotiations with providers, ensuring contract performance aligns with accessibility, quality, and cost goals.

You will cultivate relationships with physicians and providers, support cost-saving initiatives, and mentor junior colleagues while collaborating across cross-functional teams.