Senior Manager Network Management (Pacific Northwest Territory)

CVS Health

3d

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 As a part of the Northwest Network Team, the ideal candidate will: Develop and expand the network and maintain the network, identifying and contracting with healthcare providers, including hospitals, physicians, specialists, and ancillary service providers. Conduct market analysis, assess competitive positioning, and recommend strategies to maintain a competitive edge. Interface with the finance team on budgeting, cost analysis, and financial forecasting, to manage the financial aspects of provider network management. Consult with internal teams, including medical directors, operations managers, and other network development professionals, to align provider network performance goals and objectives. Provide continuous recommendations to senior leadership to guide decision-making and ensure close alignment with the organization's strategic goals and objectives. Manage provider contract performance and supports the development and implementation of strategic, value-based contract relationships. Apply highly-developed knowledge to negotiate Network contracts with healthcare providers, establishing reimbursement rates, service agreements, and performance metrics. Advise on provider performance, network adequacy, geographical coverage, and member satisfaction, and makes necessary network modifications or expansions. Implement improvement initiatives to ensure that network providers meet all applicable regulatory requirements and quality standards. This role will manage key and critical network relationships.

Requirements

• 7+ years of contract negotiation experience, working with healthcare providers, including hospitals, physicians, specialists and ancillary service providers.
• Experience with Commercial and Medicare lines of businesses.
• 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

• Experience serving as a coach/mentor to other network staff.
• Preferred Locations: Washington, Oregon, Idaho or Alaska

Responsibilities

• Develop and expand the network and maintain the network, identifying and contracting with healthcare providers, including hospitals, physicians, specialists, and ancillary service providers.
• Conduct market analysis, assess competitive positioning, and recommend strategies to maintain a competitive edge.
• Interface with the finance team on budgeting, cost analysis, and financial forecasting, to manage the financial aspects of provider network management.
• Consult with internal teams, including medical directors, operations managers, and other network development professionals, to align provider network performance goals and objectives.
• Provide continuous recommendations to senior leadership to guide decision-making and ensure close alignment with the organization's strategic goals and objectives.
• Manage provider contract performance and supports the development and implementation of strategic, value-based contract relationships.
• Apply highly-developed knowledge to negotiate Network contracts with healthcare providers, establishing reimbursement rates, service agreements, and performance metrics.
• Advise on provider performance, network adequacy, geographical coverage, and member satisfaction, and makes necessary network modifications or expansions.
• Implement improvement initiatives to ensure that network providers meet all applicable regulatory requirements and quality standards.
• Manage key and critical network relationships.

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
• Number of Employees: 5,001-10,000 employees