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12 days
Not Specified
Not Specified
$48.84/hr - $77.20/hr (Estimated)
<p>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.Position SummaryThis position supports Ancillary Provider Contracting and Relationship Management for the Commercial and Medicare Segments.Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with ancillary providers in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, compliance, quality, and financial goals and cost incentivesManages contract performance in support of network quality, availability, and financial goals and strategiesRecruit providers as needed to ensure attainment of network expansion and adequacy targetsCollaborates cross -functionally to contribute to provider compensation and pricing development activities, recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activitiesIntegrates cross-functional collaboration to contribute to provider compensation and pricing development activities and recommendations for negotiations and reimbursement modeling activities.Identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activitiesProvides ancillary network development, maintenance, and refinement activities and strategies in support of cross-market network management unitAssists with the design, development, management, and/or implementation of strategic network configurations, including integration activitiesOptimizes interaction with assigned providers and internal business partners to manage relationships and ensure providers needs are metEnsures resolution of escalated issues related, but not limited to, claims payment, contract interpretation, and parameters or accuracy of provider contract or demographic informationCoaches more junior colleagues in techniques, processes, and responsibilities.Required Qualifications:7-10 years of Healthcare experience5+ years of Provider Contract Network and Negotiation experience preferably within the ancillary space.Proven working knowledge of competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements3+ years related experience Commercial HMO, PPO products knowledge3+ years related experience Medicare and/or Medicaid products knowledgeMust reside in Ohio or KentuckyPreferred Qualifications:Intermediate knowledge of Microsoft Office, specifically Excel and PowerPointA ready business acumen and the ability to balance and articulate competing priorities while making decisionsStrong and persuasive communication skills, especially written communications, with external stakeholdersStrong critical thinking, problem resolution and interpersonal skillsAdept at execution and delivery (planning, delivering, and supporting) skillsAdept at collaboration and teamworkA growth mindset (agility and developing yourself and others) skillsEducationBachelor's Degree or equivalent professional experiencePay RangeThe typical pay range for this role is:$67,900.00 - $165,954.00This 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. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.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, and other resources, based on eligibility.Additional details about available benefits are provided during the application process and on Benefits Moments.We anticipate the application window for this opening will close on: 05/31/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.</p>
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