Contract Negotiation Manager
Employment Information
Job Description
Contract Negotiation Manager negotiating and executing contracts for CVS Health, focusing on network quality and financial goals. Collaborating cross-functionally to optimize provider relationships and contract performance.
Responsibilities:
- Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with ancillary providers
- Manages contract performance in support of network quality, availability, and financial goals and strategies
- Recruit providers as needed to ensure attainment of network expansion and adequacy targets
- Collaborates cross-functionally to contribute to provider compensation and pricing development activities, recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities
- Integrates cross-functional collaboration to contribute to provider compensation and pricing development activities and recommendations
- Identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities
- Provides ancillary network development, maintenance, and refinement activities and strategies in support of cross-market network management unit
- Assists with the design, development, management, and/or implementation of strategic network configurations, including integration activities
- Optimizes interaction with assigned providers and internal business partners to manage relationships and ensure providers needs are met
- Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation, and parameters or accuracy of provider contract or demographic information
- Coaches more junior colleagues in techniques, processes, and responsibilities
Requirements:
- Proven working knowledge of competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements
- 3-5 years related experience
- Commercial HMO, PPO products knowledge
- 3-5 years related experience Medicare and/or Medicaid products knowledge
- Knowledge of Kentucky/Ohio network
- Intermediate knowledge of Microsoft Office, specifically Excel and PowerPoint
- Strong and persuasive communication skills, especially written communications, with external stakeholders
- Strong critical thinking, problem resolution and interpersonal skills
- Adept at execution and delivery (planning, delivering, and supporting) skills
- Adept at collaboration and teamwork
- A growth mindset (agility and developing yourself and others) skills
Benefits:
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
- Paid time off
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access
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