Contract Negotiation Manager- Behavioral Health

Overview 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 Summary The Contract Negotiation Manager will negotiate and execute high-level review and analysis, manage dispute resolution and settlement negotiations of contracts with single and group Behavioral Health providers within a defined market. You will manage contract performance and support the development and implementation of strategic, traditional contracts and value-based contract relationships. Responsibilities Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with solo and group Behavioral Health providers for all lines of business (Medicare, commercial etc.). Manages contract performance in support of network quality, availability, and financial goals and strategies for all lines of business (Medicare, commercial etc.). Recruits Behavioral Health providers as needed to ensure attainment of network expansion and adequacy targets for all lines of business (Medicare, commercial etc.). Collaborates cross-functionally to contribute to provider compensation and pricing development activities and recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities. Responsible for identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities. Provides Behavioral Health network development, maintenance, and refinement activities and strategies in support of cross-market network management unit. Assists with the design, development, management, and or implementation of strategic network configurations, including integration activities. May optimize interaction with assigned providers and internal business partners to manage relationships and ensure provider needs are met. Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information. Required Qualifications 5 - 7 years experience in healthcare. Minimum 3+ years related experience, proven and proficient managed care network negotiating skills or in provider relations. Proven working knowledge of competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements. Strong and persuasive communication skills, especially written communications, with external stakeholders Strong critical thinking, problem resolution and interpersonal skills Adept at execution and delivery (planning, delivering, and supporting) skills A ready business acumen and the ability to balance and articulate competing priorities while making decisions Adept at collaboration and teamwork Ability to work Pacific and Mountain, time zones, preferably based in California Preferred Qualifications Versed with the California / Alaska / Arizona region Behavioral Health provider market highly preferred 3-5 years related experience Commercial HMO, PPO products knowledge 3-5 years related experience Medicare and/or Medicaid products knowledge Ideal candidate will reside in Mountain or Pacific Time Zones. Education Bachelor's degree preferred/specialized training/relevant professional qualification. Anticipated Weekly Hours 40 Time Type Full time Pay Range The Typical Pay Range For This Role Is $66,330.00 - $145,860.00 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. 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. Benefits Great Benefits For Great People. We 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. Legal Notice Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. #J-18808-Ljbffr CVS Health