Senior Manager, Network Management Hybrid- NH, CT, or anywhere in NE Region

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose : Bringing our heart to every moment of your health.

This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand with heart at its center our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary

The Senior Manager negotiates, executes, conducts high level review and analysis, dispute resolution and / or settlement negotiations of contracts.

Works with larger and more complex, market / regional / national based groups / systems in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals and cost initiatives.

The Senior Manager will be responsible for contracting and implementing fee for service and some value-based agreements with key physician groups, facilities, and ancillary providers to support commercial, Medicare, and individual exchange networks.

This person will also work collaboratively with Aetna and CVS departments to identify initiatives to improve physician performance and quality of care provided to our members.

Recruits providers as needed to ensure attainment of network expansion and adequacy targets. Accountable for cost arrangements within defined groups.

Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities.

This is an individual contributor role. Candidates need to reside in the Northeast Region.

Required Qualifications

• Minimum 5+ years related healthcare experience and comprehensive level of negotiating with individual or complex provider systems or groups.
• Proven working knowledge of provider financial issues and competitor strategies, large / complex contracting options, financial / contracting arrangements.
• Strong project management and organizational skills
• Proficient in Network Management, Provider Contracting
• Experience contracting with hospital systems and / or large provider groups.
• Skilled at collaborating and working across a complex matrixed organization.
• Strong communication, critical thinking, problem resolution and interpersonal skills.

Preferred Qualifications

• Commercial, individual exchange, Medicare experience
• Advanced Excel experience including pivot tables and v-lookup function, PowerPoint and ideally QuickBase.
• Minimum of 5 years of healthcare experience including contracting, medical economics and field or national network experience

Education

Bachelor’s Degree or equivalent combination of education and experience

Pay Range

The typical pay range for this role is :

$67,900.00 - $174,200.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.

The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

This position also includes an award target in the company’s equity award program.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.

The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.

The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits.

CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.

As for time off, Company employees enjoy Paid Time Off ( PTO ) or vacation pay, as well as paid holidays throughout the calendar year.

Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.