Senior Manager, Provider Contract Negotiation (Georgia)

CVS Health • Duluth, GA

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 As a part of the Georgia Network Team, the ideal candidate will: Develop and expand 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

• 5+ years of contract negotiation experience, working with healthcare providers, including hospitals, physicians, specialists and ancillary service providers.
• Must reside in Georgia
• 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

Nice To Haves

• Experience serving as a coach/mentor to other network staff.
• Masters Degree

Responsibilities

• Develop and expand 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

• 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: Senior