Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
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.
Job Summary
Negotiates, executes, and analyzes contracts with larger and more complex healthcare group/system providers, focusing on maintaining and enhancing the provider network while meeting accessibility, quality, and financial goals. Handles dispute resolution and settlement negotiations, ensuring compliance with company standards and regulatory requirements. Leverages extensive negotiation skills and working knowledge of provider financial issues to optimize contracts and collaborates with large hospitals and health systems to achieve successful contracting outcomes, all while supporting cost-saving initiatives and the growth of the provider network.
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What you will do
- Negotiates, executes, and conducts high-level review and analysis of contracts with larger and more complex group/system providers while ensuring contracts align with company standards and goals related to accessibility, quality, and financial performance.
- Manages and facilitates dispute resolution processes to address issues arising from provider contracts, ensuring equitable solutions.
- Leads contract settlement negotiations, striving to reach mutually beneficial agreements with providers that maintain and enhance the provider network.
- Implements strategies to enhance and expand the provider network, while ensuring it meets accessibility and quality standards.
- Aligns provider contracts with financial goals and cost-saving initiatives, ensuring that contracts support the company's financial objectives.
- Conducts comprehensive reviews and analyses of provider contracts, identifying areas for improvement and optimization.
- Ensures that all provider contracts adhere to regulatory requirements, maintaining compliance with healthcare regulations.
- Utilizes working knowledge of provider financial issues and competitor strategies to inform negotiation and contracting decisions.
- Facilitates leadership, guidance, and mentorship to a team of professionals by setting strategic objectives, monitoring team performance, providing training and development opportunities, and fostering a collaborative and innovative work environment.
- A minimum of 7 years related experience, proven and proficient managed care network negotiating skills.
- Adept at problem solving and decision-making skills.
- Adept at collaboration and teamwork
- Adept at growth mindset (agility and developing yourself and others) skills.
- Adept at execution and delivery (planning, delivering, and supporting) skills.
- Adept at business intelligence
- Provider Data Management
- Claim and/or Customer Service Experience
- Bachelor's degree preferred or equivalent professional work experience.
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
We anticipate the application window for this opening will close on: 10/31/2024
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.