Senior Manager, Network Management (Connecticut)

CVS Health

7d

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 Negotiates, executes, and analyzes contracts with larger and more complex healthcare group/system providers, focusing on maintaining and enhancing the provider network while meeting accessibility, quality, and financial goals. Handles dispute resolution and settlement negotiations, ensuring compliance with company standards and regulatory requirements. Leverages extensive negotiation skills and working knowledge of provider financial issues to optimize contracts, and collaborates with large hospitals and health systems to achieve successful contracting outcomes, all while supporting cost-saving initiatives and the growth of the provider network.

Requirements

• A minimum 7 years of experience contracting with providers within the healthcare industry.
• A minimum 5 years of direct hospital contracting experience.
• Experience with Commercial and Medicare lines of business.
• Adept at problem solving and decision making skills, based on data and trends.
• Adept at collaboration and teamwork
• Addition skills include a growth mindset (agility and developing yourself and others) skills; execution and delivery (planning, delivering, and supporting) skills; business intelligence and communication skills across multiple levels of leadership.
• Ability to travel within assigned territory if needed

Nice To Haves

• Strong understanding of the Connecticut market, including local payer and provider dynamics.
• Hands-on experience with value-based contracting and alternative payment arrangements.

Responsibilities

• Negotiates, executes, and conducts high-level review and analysis of contracts with larger and more complex group/system providers while ensuring contracts align with company standards and goals related to accessibility, quality, and financial performance.
• Manages and facilitates dispute resolution processes to address issues arising from provider contracts, ensuring equitable solutions.
• Leads contract settlement negotiations, striving to reach mutually beneficial agreements with providers that maintain and enhance the provider network.
• Implements strategies to enhance and expand the provider network, while ensuring it meets accessibility and quality standards.
• Aligns provider contracts with financial goals and cost-saving initiatives, ensuring that contracts support the company's financial objectives.
• Conducts comprehensive reviews and analyses of provider contracts, identifying areas for improvement and optimization.
• Ensures that all provider contracts adhere to regulatory requirements, maintaining compliance with healthcare regulations.
• Utilizes working knowledge of provider financial issues and competitor strategies to inform negotiation and contracting decisions.
• Facilitates leadership, guidance, and mentorship to a team of professionals by setting strategic objectives, monitoring team performance, providing training and development opportunities, and fostering a collaborative and innovative work environment.

Benefits

• This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families.
• The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
• Additional details about available benefits are provided during the application process and on Benefits Moments.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level