Payer Relations, Manager (multiple openings)

CVS Health • Columbus, OH

446d • $54,300 - $159,120

About The Position

The Manager, Payer Relations at CVS Health is responsible for leading contracting efforts within the Retail Health division as Minute Clinic locations expand into Primary Care. This role focuses on designing and developing contracts, maintaining relationships with payers, and enhancing contractual networks of care for members. The position requires negotiation of contracts, evaluation of provider performance, and collaboration with various stakeholders to ensure alignment with business objectives and financial goals.

Requirements

• Minimum 5 years work experience managing payer and/or provider contracting for fee for service and/or value-based contracting.
• Familiarity with contract analytics, implementation, and ongoing contract management.
• Proficient in Microsoft Office Products, specifically Excel.
• Ability to think independently in a fast-paced environment where priorities change quickly.
• Adept at problem solving and decision-making skills.
• Adept at collaboration and teamwork skills.
• Adept at growth mindset skills.
• Adept at execution and delivery skills.

Nice To Haves

• Bachelor's degree preferred or specialized training/relevant professional qualification.

Responsibilities

• Act as a top-level specialist in contract negotiations with payers, establishing reimbursement rates, terms, and conditions.
• Create and maintain strong working relationships with payer representatives and key decision-makers.
• Advise on the development of the organization's payer strategy by analyzing market trends and identifying emerging opportunities.
• Evaluate payer performance metrics and identify areas for improvement.
• Develop and execute payer agreements in collaboration with legal, finance, and operations teams.
• Interface with internal stakeholders to ensure timely and accurate fee schedule implementations.
• Correct conflicts, address grievances, and negotiate satisfactory resolutions of payer-related issues.
• Consult on industry trends, regulatory changes, and healthcare policy developments that could impact payer relations.
• Provide continuous recommendations to senior leadership to guide decision-making.

Benefits

• Full range of medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Employee Stock Purchase Plan.
• Fully-paid term life insurance plan.
• Short-term and long-term disability benefits.
• Well-being programs.
• Education assistance and free development courses.
• CVS store discount and discount programs with participating partners.
• Paid Time Off (PTO) and paid holidays.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Health and Personal Care Retailers
• Education Level: Bachelor's degree