[Hiring] Senior Network Contracting Negotiation Manager @CVS Health

Role Description

The Network Management Senior Manager applies highly-developed knowledge to negotiate complex Network contracts with healthcare providers, establishing reimbursement rates, service agreements, and performance metrics.

• Advises on provider performance, network adequacy, geographical coverage, and member satisfaction, and makes necessary network modifications or expansions.
• Implements improvement initiatives to ensure that network providers meet all applicable regulatory and quality standards.
• Develops and expands the network, identifying and contracting with healthcare providers, including hospitals, physicians, specialists, and ancillary service providers.
• Conducts market analysis, assesses competitive positioning, and recommends strategies to maintain a competitive edge.
• Interfaces with the finance team on budgeting, cost analysis, and financial forecasting, to manage the financial aspects of provider network management.
• Consults with internal teams, including medical directors, operations managers, and network development professionals, to align provider network performance goals and objectives.
• Provides continuous recommendations to senior leadership to guide decision-making and ensure close alignment with the organization's strategic goals and objectives.

Qualifications

• 7+ years healthcare industry experience
• 5+ years related experience and comprehensive level of provider negotiating skills with successful track record negotiating contracts with complex provider systems or groups.
• Must reside in Michigan
• Critical thinking to maintain cost management and a fully engaged network of participating hospitals, ancillaries and providers.
• Microsoft Office/Excel proficient
• Ability to travel in assigned market up to 10-15% of the time as needed (Michigan).

Preferred Qualifications

• Experience using contract management systems
• Relevant experience and understanding of the local healthcare market and payer dynamics
• Demonstrated analytical aptitude with proven capability to troubleshoot complex issues
• Skilled at connecting data to daily execution of tasks

Education

• Bachelor’s Degree or equivalent professional work experience.

Pay Range

The typical pay range for this role is: $75,400.00 - $165,954.00. 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.