Senior Manager, Provider Network Strategy
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Job Description
Senior Manager shaping Louisiana Medicaid provider network strategy at CVS Health. Driving network compliance, provider partnerships, market growth, and cost-effective member access.
Responsibilities:
- Monitor and manage proactive provider network strategy for the Louisiana Medicaid Market
- Ensure compliance with Louisiana Department of Health and NCQA network standards
- Monitor monthly progress toward annual network development plan objectives
- Provide alternative strategies for at-risk network goals
- Conduct market analysis and assess competitive positioning
- Recommend strategies for market growth and provider partnerships
- Build a prioritized pipeline of provider recruiting targets
- Create departmental training materials for identifying appropriate provider targets
- Design a network management activity dashboard showing contracting productivity, project status, and escalation requests
- Develop and deploy engagement and change strategies to accelerate adoption of processes, tools, and operational practices
- Provide real-time recommendations to senior leadership
- Partner with matrixed leaders to diagnose organizational challenges and identify solutions
Requirements:
- 7+ years of experience in Medicaid managed care provider contracting, provider engagement, performance management, or value-based contracting
- Strong understanding of Medicaid provider environment and reimbursement models
- Experience with internal and external stakeholder engagement and partnership
- Must live in the Louisiana market
- Knowledge of Louisiana Medicaid landscape
- Solution-driven approach to provider challenges
- Change-enablement strategies and execution experience
- Adept at business intelligence
- Bachelor's degree or equivalent work experience
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
- Equity award program
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