CVS Health

Bringing our heart to every moment of your health.

Contract Negotiation Manager

ManagerManagerFull TimeRemoteTeam 10,001+Since 1963H1B No SponsorCompany SiteLinkedIn

Location

Texas

Posted

24 days ago

Salary

$60.3K - $132.6K / year

Bachelor Degree5 yrs expEnglish

Job Description

• Negotiates competitive contracts with health care providers using pre-determined internal guidelines and financial standards • Negotiates contract language in accordance with Aetna standards, engaging other departments as needed for review and approval of contract terms outside the standards • Manages contract performance and works with various internal departments to address questions, issues, and activities related to execution, loading, and ongoing maintenance of provider contracts • Manages relationships with key providers and ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information • Negotiates settlements as needed • May recruit providers as needed to ensure network adequacy and achievement of network expansion goals • Maintains accountability for specific medical cost initiatives

Job Requirements

  • 5 to 7 years of experience negotiating contracts with ancillary providers, physician groups, and IPAs
  • 5 to 7 years of working knowledge of contracting options, provider reimbursement methodologies and terms, and contract setup
  • Understanding of provider financial issues, industry standard payment policies, regulatory requirements, and competitor strategies
  • Must be proficient in Word, Excel, and Microsoft Office
  • Medicaid contracting experience preferred
  • Proficiency in the QNXT application preferred
  • Strong critical thinking, problem resolution, organization, communication, and interpersonal skills
  • Able to successfully manage multiple negotiations, issues, and other tasks to ensure completion and meet deadlines
  • Able to manage expectations and maintain strong relationships, both internally and externally
  • Candidates should reside in Texas

Benefits

  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost programs including wellness screenings
  • Tobacco cessation and weight management programs
  • Confidential counseling and financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Colleague assistance programs
  • Tuition assistance
  • Retiree medical access
  • Many other benefits depending on eligibility

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