Provider Network Contracting Manager
1 month ago
Job Summary
As a Senior Provider Network Contracting Manager at CVS Health, you will play a critical role in maintaining and enhancing our provider networks while meeting and exceeding accessibility, compliance, quality, and financial goals and cost initiatives. This position requires a strong understanding of physician reimbursement methodologies and contracting strategies, as well as excellent communication and negotiation skills.
Key Responsibilities
- Reviews and analyzes complex Medicaid contracts with health systems, physician groups, and behavioral health providers.
- Negotiates and executes contracts in accordance with company standards.
- Develops and implements provider compensation and pricing strategies.
- Manages contracts through language and compliance reviews.
- Serves as a liaison to internal colleagues to interpret contracts, drive cost savings, and resolve claims and other service issues.
Requirements
We are seeking a highly skilled and experienced professional with a proven track record in provider contracting and negotiation. The ideal candidate will have 7-10 years of work experience in a provider contracting role, with Medicaid and/or behavioral health experience preferred. They will also possess strong communication, critical thinking, project management, and problem-solving skills, as well as the ability to negotiate complex healthcare provider contracts.
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