Payor Relations & Contracting Manager

CVS Health•Dayton, OH

23h•$60,300 - $132,600•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. This is an individual contributor role. The Manager of Contract Negotiation develops and maintains strategic relationships with physician partners across the Northern Ohio market, leading contract management and provider relations initiatives that support Commercial and Medicare lines of business. In addition to managing these relationships, the Manager develops, reviews, analyzes, and executes provider contracts. They ensure proper implementation of negotiated agreements and monitor contract performance to align with accessibility, compliance, quality, financial, and cost objectives.

Requirements

5 years of experience leading or supporting operational functions within healthcare administration or health insurance environments.
3+ years managing provider relationships and overseeing contract management functions.
Demonstrated ability to partner with internal and external stakeholders to identify root causes, develop solutions, and drive issue resolution within established timelines.
Proficiency in Microsoft Word, Excel, and PowerPoint.

Nice To Haves

3+ years experience with provider contract negotiation or provider relations experience
Experience with EPDB (Enterprise Provider Database, SCM (Strategic Contract Manager), and Provider Data Management.
Experience with Commercial and Medicare lines of business.
Exceptional written and verbal communication skills, particularly with external stakeholders.
Strong critical thinking, problem-solving, and interpersonal skills.
Candidates residing in Ohio are strongly preferred.

Responsibilities

Lead the development and execution of innovative programs to advance contract negotiation initiatives across the organization.
Anticipate industry changes, evaluate their impact, and formulate strategic responses.
Design and implement systems to recruit providers, supporting network expansion and adequacy goals.
Conduct competitive analyses to inform reimbursement strategies.
Foster cross-functional collaboration to enhance provider compensation methodologies and analyze financial impacts of reimbursement models.
Recommend strategies to address cost challenges and drive cost-saving initiatives and settlement activities.
Support network development, maintenance, and optimization to achieve company and market objectives.
Mentor colleagues on best practices, processes, and responsibilities to strengthen team capabilities.