Contract Negotiation Manager- Behavioral Health

CVS Health

4d•$66,330 - $145,860•Remote

About The Position

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. The Contract Negotiation Manager will negotiate and execute high-level review and analysis, manage dispute resolution and settlement negotiations of contracts with single and group Behavioral Health providers within a defined market. You will manage contract performance and support the development and implementation of strategic, traditional contracts and value-based contract relationships.

Requirements

5 - 7 years experience in healthcare.
Minimum 3+ years related experience, proven and proficient managed care network negotiating skills or in provider relations.
Proven working knowledge of competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements.
Strong and persuasive communication skills, especially written communications, with external stakeholders
Strong critical thinking, problem resolution and interpersonal skills
Adept at execution and delivery (planning, delivering, and supporting) skills
A ready business acumen and the ability to balance and articulate competing priorities while making decisions
Adept at collaboration and teamwork
Ability to work Pacific and Mountain, time zones, preferably based in California or Pacific Northwest.

Nice To Haves

Versed with the California / Oregon / Washington region Behavioral Health provider market highly preferred
3-5 years related experience Commercial HMO, PPO products knowledge
3-5 years related experience Medicare and/or Medicaid products knowledge
Ideal candidate will reside in Mountain or Pacific Time Zones.

Responsibilities

Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with solo and group Behavioral Health providers for all lines of business (Medicare, commercial etc.).
Manages contract performance in support of network quality, availability, and financial goals and strategies for all lines of business (Medicare, commercial etc.).
Recruits Behavioral Health providers as needed to ensure attainment of network expansion and adequacy targets for all lines of business (Medicare, commercial etc.).
Collaborates cross-functionally to contribute to provider compensation and pricing development activities and recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities.
Responsible for identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities.
Provides Behavioral Health network development, maintenance, and refinement activities and strategies in support of cross-market network management unit.
Assists with the design, development, management, and or implementation of strategic network configurations, including integration activities. May optimize interaction with assigned providers and internal business partners to manage relationships and ensure provider needs are met. Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information.