Contract Negotiation Manager
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Job Description
CVS Health contract manager negotiating provider agreements, resolving disputes, and managing provider network performance. Supporting healthcare network quality, accessibility, compliance, and financial goals.
Responsibilities:
- Negotiate, execute, review, and analyze contracts and handle dispute resolution and settlement negotiations with providers
- Manage contract performance in support of network quality, availability, and financial goals
- Recruit providers to achieve network expansion and adequacy targets
- Collaborate on provider compensation, pricing development, contractual information, negotiation, and reimbursement modeling activities
- Identify cost issues and recommend cost-saving initiatives and settlement activities
- Provide network development, maintenance, and refinement strategies for cross-market network management
- Assist with strategic network configuration, integration, and implementation activities
- Optimize interactions with assigned providers and internal business partners
- Resolve escalated issues involving claims payment, contract interpretation, and provider contract or demographic information
- Interpret contractual requirements, including federal and state regulations and NCQA
Requirements:
- 5+ years of working knowledge of the healthcare industry, including competitor strategies, complex contracting options, financial and contracting arrangements, and regulatory requirements
- 3+ years of experience in provider relationship management or related healthcare roles
- Proven and proficient contract management skills
- Strong communication, critical thinking, problem-resolution and interpersonal skills
- Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook)
- Bachelor's degree preferred or a combination of professional work experience and education
- Candidates residing on the West Coast are strongly preferred
Benefits:
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being
- CVS Health bonus, commission or short-term incentive program in addition to base pay
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