[Hiring] Senior Provider Network Contracting @CVS Health

Role Description

Negotiates, executes, and analyzes contracts with larger and more complex healthcare group/system providers, focusing on maintaining and enhancing the provider network while meeting accessibility, quality, and financial goals.

• Handles dispute resolution and settlement negotiations, ensuring compliance with company standards and regulatory requirements.
• Leverages extensive negotiation skills and working knowledge of provider financial issues to optimize contracts.
• Collaborates with large hospitals and health systems to achieve successful contracting outcomes, supporting cost-saving initiatives and the growth of the provider network.
• Conducts high-level review and analysis of contracts with larger and more complex group/system providers.
• Manages and facilitates dispute resolution processes to address issues arising from provider contracts.
• Leads contract settlement negotiations, striving to reach mutually beneficial agreements with providers.
• Implements strategies to enhance and expand the provider network, ensuring it meets accessibility and quality standards.
• Aligns provider contracts with financial goals and cost-saving initiatives.
• Conducts comprehensive reviews and analyses of provider contracts, identifying areas for improvement and optimization.
• Ensures compliance with healthcare regulations in all provider contracts.
• Utilizes knowledge of provider financial issues and competitor strategies to inform negotiation and contracting decisions.
• Facilitates leadership, guidance, and mentorship to a team of professionals.

Qualifications

• A minimum of 7 years of experience contracting with providers within the healthcare industry.
• A minimum of 5 years of direct hospital contracting experience.
• Experience with Commercial, Medicare, and Medicaid lines of business.
• Adept at problem solving and decision making based on data and trends.
• Adept at collaboration and teamwork.
• Possesses a growth mindset (agility and developing yourself and others).
• Strong execution and delivery skills (planning, delivering, and supporting).
• Business intelligence and communication skills across multiple levels of leadership.
• Ability to travel within assigned territory if needed.

Preferred Qualifications

• Strong understanding of the IL and MO market, including local payer and provider dynamics.
• Hands-on experience with value-based contracting and alternative payment arrangements.

Education

• Bachelor's degree or a combination of professional work experience and education.

Pay Range

The typical pay range for this role is: $67,900.00 - $182,549.00. 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.

Company Description

We’re building a world of health around every individual — shaping a more connected, convenient, and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable, and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family, and one community at a time.