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Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
Position Summary
The Contract Negotiation Senior Manager negotiates, executes, conducts deep-dive review and analysis of dispute resolution and/or settlement negotiations of contracts with larger and more complex, market/regional/national based group/system providers including but not limited to Health Systems/Hospitals, large PCP groups, pediatricians, advanced specialist groups, hospital based providers, ancillary providers, ambulatory surgical centers, behavioral health providers, etc. in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals and cost initiatives
Other Responsibilities Include but are not limited to:
Recruit providers as needed to ensure attainment of network expansion goals, achieve regulatory and/or internal adequacy targetsSupport health plan with expansion initiatives or other contracting activities as neededInitiates, coordinates and own the contracting activities to fulfillment including receipt and processing of contracts and documentation and pre- and post-signature review of contracts and language modification according to Aetna’s established policiesResponsible for auditing, building, and loading contracts, agreements, amendments and/or fee schedules in contract management systems per Aetna’s established policiesConducts research, analysis and/or audits to identify issues and propose solutions to protect data, contract integrity and performanceManages contract performance and supports the development and implementation of value-based contract relationships in support of business strategiesCollaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activitiesProvides Subject Matter Expert support for questions related to recruitment initiatives, contracting, provider issues/resolutions, related systems and information containedProvide guidance and share expertise to others on the teamUnderstanding of Value Based contracting and negotiationsManage high level projects and recruitment initiatives with interdepartmental resources and/or cross functional stakeholdersMay participates in JOC meetingsSupports or assists with operational activities that may include, but are not limited to, database management and contract coordinationOrganizing and transforming information into comprehensible structuresUsing data to predict trends in the customer base and the consumer population as a wholePerforming statistical analysis of dataUsing tools and techniques to visualize data in easy-to-understand formats, such as diagrams and graphsPreparing reports and presenting these to leadershipEngage with providers and quickly move the providers though contracting processes in order to ensure meeting network adequacy requirementsThis is an individual contributor role
Required Qualifications
Preferred Qualifications
Education
Bachelor’s degree desired or equivalent professional work experience
Pay Range
The typical pay range for this role is:
$82,940.00 - $182,549.40
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit Benefits | CVS Health
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.