Provider Contract Negotiation Senior Manager

Company: CVS Health
Location: Richmond
Posted on: September 24, 2022

Job Description:

Job DescriptionAs a Provider Contract Negotiation Senior Manager (healthcare), you will serve as the senior level contract negotiator for providers within the Aetna Better Health of Virginia Medicaid Health Plan segment. This is an excellent opportunity to interface with Executive Leadership both internally and externally. As a seasoned healthcare provider contract negotiator professional, you will use your years of expertise to grow our business through expanding and maintaining our Medicaid MCO provider network in Virginia. You will accomplish this through: --- Negotiation of contracts with larger and more complex, market/regional/national based group/system hospitals and providers --- Maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals and cost initiatives.--- Managing contract performance and supporting the development and implementation of value based contract relationships in support of business strategies--- Recruiting major providers as needed to ensure attainment of network expansion and adequacy targets--- Writing and updating network policies in accordance with state regulations and NCQA requirements--- Serving as SME for less experienced team members and internal partnersYour success will be driven by your ability to grow and maintain the provider network for the assigned book of business and achieve above average provider satisfaction scores. You will function as a senior negotiator for the contracting team, and your ability to influence others to deliver results for the health plan will also be a key factor in your success. Your understanding of the Virginia healthcare landscape and managed care environment, as well as keeping up to date on market trends, will enable you to position CVS Health/Aetna Better Health programs and solutions effectively to decision makers. The individual contributions you will make will position CVS Health/Aetna Better Health for long term growth in the competitive Medicaid MCO marketplace. This position is located in Virginia and has the ability to work remotely. You must have ability to travel up to 20% of the time.Pay RangeThe typical pay range for this role is:Minimum: 75,400Maximum: 158,300Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.Required Qualifications--- 7 years of work experience (graduate level education may substitute)--- 5+ years related experience and expert level negotiation skills with successful track record negotiating complex contracts with hospital systems and large provider/ancillary groups --- Command of financials and healthcare pricing strategies--- Located anywhere in Virginia with ability to work East Coast time zone hours (remote work flexible)--- Ability to travel within the Commonwealth of Virginia (20%)COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications--- Medicaid MCO experience --- Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, healthcare financial/contracting arrangementsand Virginia DMAS requirementsEducation- Bachelor's degree required or equivalent experience- Master's Degree preferred in Business or Healthcare AdministrationBusiness OverviewBring your heart to CVS HealthEvery 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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Keywords: CVS Health, Richmond , Provider Contract Negotiation Senior Manager, Executive , Richmond, Virginia