Provider Contract Negotiation Manager

CVS Health

3d • 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. Position Summary Constructs negotiation, execution, review, and analysis of contracts. Delivers dispute resolution and settlement negotiations with providers. Ensures contract performance aligns with accessibility, compliance, quality, financial, and cost goals.

Requirements

• 2+ years of experience in provider contracting, claims management or patient management.
• 2+ years’ experience working with/or in a Claims environment.
• 1-2 years’ experience that includes ACAS and HRP claim platforms, products, and benefits; patient management; provider relations or claims management.
• This is a remote position

Nice To Haves

• Knowledge/experience with National Advantage Program within Aetna.
• Aetna systems (Smart Front End, ASD, ATV, HRP, MedCompass. RUMBA – EPDB, EWMP, Rate Inquiry, Contract Inquiry)

Responsibilities

• Negotiate single case agreements for episodes of care on a pre-service basis.
• Participation/engagement of looking at forecasts changes within the Contract Negotiations industry, development of business impact assessments, and modification strategies with the aid of process improvement methodologies.
• Determines recommendations to manage cost issues and support cost-saving initiatives and settlement activities
• Develop, maintain, and enhance working relationships with physicians/providers and local network and patient management teams in the markets within Aetna.
• Coaches more junior colleagues in techniques, processes, and responsibilities.

Benefits

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 5,001-10,000 employees