Lead Director, Network Management
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 Lead Director, Network Management is accountable for designing conceptual models, initiative planning, and negotiating Commercial\Medicare Advantage agreements with Texas providers, including health systems, clinically integrated networks, IPAs, FQHCs and others, in accordance with company standards in order to maintain and enhance Commercial\Medicare Advantage provider networks, while working cross functionally to ensure consistency with all contracting strategies and meeting and exceeding accessibility, quality, compliance, regulatory, and financial goals and cost initiatives.
Requirements
- 10+ years related experience
- Expert level negotiation skills with successful track record negotiating contracts with large or complex national vendors/providers
- Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements
- Demonstrated ability to identify and manage initiatives that improve total medical cost and quality
- Health Plan/Payer or Provider Systems experience
- Must reside in Texas
Nice To Haves
- Experience with Commercial\Medicare Advantage Fee-for-Service contract
- Commercial\Medicare Advantage regulatory experience
- Commercial\Medicare Advantage contracting & setup experience
- Working Knowledge of Value-Based Contracting
Responsibilities
- Designing conceptual models
- Initiative planning
- Negotiating Commercial\Medicare Advantage agreements with Texas providers, including health systems, clinically integrated networks, IPAs, FQHCs and others
- Maintaining and enhancing Commercial\Medicare Advantage provider networks
- Ensuring consistency with all contracting strategies
- Meeting and exceeding accessibility, quality, compliance, regulatory, and financial goals and cost initiatives
Benefits
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- CVS Health bonus
- Commission
- Short-term incentive program
- Equity award program
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What This Job Offers
Job Type
Full-time
Career Level
Director
Education Level
Associate degree
