CVS Health
Bringing our heart to every moment of your health.
Contract Negotiation Manager
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
Related Guides
Related Categories
Related Job Pages
More Manager Jobs
Manager24 days ago
Full TimeRemoteTeam 1,001-5,000Since 2010H1B Sponsor
MEP Construction Manager managing data center construction projects at Vantage Data Centers
United States
Manager24 days ago
Full TimeRemoteTeam 1,001-5,000Since 2010H1B Sponsor
MEP Construction Manager overseeing data center projects for Vantage Data Centers
United States
Manager24 days ago
Full TimeRemoteTeam 5,001-10,000
As the SAP Change Enablement Leader, you will be responsible for developing and executing the change enablement processes that support Belden's global SAP implementation. You will ensure that SAP process and system changes are effectively communicated, adopted, and integrated, wi...
SAPChange ManagementProgram ManagementLeadershipTraining DeliveryStakeholder ManagementGlobal Transformation
Manager24 days ago
Full TimeRemoteTeam 10,001+Since 1969H1B No Sponsor
Manager of Field Visual Merchandising for Banana Republic Factory Stores
California