[Hiring] Lead Director, Network Management @CVS Health

Role Description

The Lead Director, Network Management is accountable for:

• Designing conceptual models
• Initiative planning
• Negotiating Commercial/Medicare Advantage agreements with Texas providers, including health systems, clinically integrated networks, IPAs, FQHCs, and others
• Maintaining and enhancing Commercial/Medicare Advantage provider networks
• Working cross-functionally to ensure consistency with all contracting strategies
• Meeting and exceeding accessibility, quality, compliance, regulatory, and financial goals and cost initiatives

Qualifications

• 10+ years related experience and expert level negotiation skills with a successful track record negotiating contracts with large or complex national vendors/providers
• Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements
• Demonstrated ability to identify and manage initiatives that improve total medical cost and quality
• Health Plan/Payer or Provider Systems experience
• Must reside in Texas

Requirements

• Experience with Commercial/Medicare Advantage Fee-for-Service contract
• Commercial/Medicare Advantage regulatory experience
• Commercial/Medicare Advantage contracting & setup experience
• Working knowledge of Value-Based Contracting

Education

• Bachelor's degree or equivalent professional work experience

Pay Range

The typical pay range for this role is:

• $100,000.00 - $231,540.00

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.

Benefits

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include:

• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources, based on eligibility

Additional details about available benefits are provided during the application process.