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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
Reviews, analyzes, negotiates, and executes complex Medicaid contracts with health systems, physician groups, and behavioral health providers in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, compliance, quality, and financial goals and cost initiatives. Collaborates cross-functionally to develop provider compensation and pricing strategies and manages contracts through language and compliance reviews. Serves as a liaison to internal colleagues to interpret contracts, drive cost savings, resolve claims and other service issues.
Required Qualifications
7-10 years work experience in a provider contracting role, Medicaid and/or behavioral health experience preferred.
Proven working knowledge of physician reimbursement methodologies and contracting strategies.
Strong communication, critical thinking, project management and problem-solving skills.
A willingness to actively interact with providers and have complex conversations.
Working knowledge of Microsoft applications.
Adept at negotiating complex healthcare provider contracts
Preferred Qualifications
Internal applicants: working knowledge of QuickBase, QNEXT, PRMS and KIT systems preferred.
Education
Bachelor's degree or equivalent professional work experience.
Pay Range
The typical pay range for this role is:
$67,900.00 - $149,328.00
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.