Manager

CVS Health Provider Contracting RoleWe'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 is an individual contributor role. This role will contract and manage provider negotiations with physicians and ancillary providers throughout the state.Manages contract performance and drives the development and implementation of value-based contract relationships in support of business strategies.Project management skills to prioritize competing priorities and effectively communicate provider contracting scenarios with attention to detail based on a thorough evaluation of provider data using internal tools.Recruits providers as needed to ensure attainment of network expansion and adequacy targets. Accountable for cost arrangements within defined groups.Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities.Responsible for identifying and managing cost issues and collaborating cross functionally to execute significant cost saving initiatives.Represents company with high visibility constituents, including customers and community groups. Promotes collaboration with internal partners.Evaluates, helps formulate, and implements the provider network strategic plans to achieve contracting targets and manage medical costs through effective provider contracting to meet state contract and product requirements. Collaborates with internal partners to assess effectiveness of tactical plan in managing costs.May optimize interaction with assigned providers and internal business partners to facilitate 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 QualificationsMinimum of 5 years of related experience, with demonstrated proficiency in managed care network negotiations.Minimum of 3 years of experience in provider relations, with demonstrated success in strengthening provider partnerships, increasing engagement, and contributing to network performance and access goals.Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook).Candidates must reside in the state of Florida.Preferred QualificationsDemonstrated ability to build and maintain strong, long-term relationships with provider partners.Demonstrated ability to communicate effectively across all levels of the organization, evidenced by successful cross-functional collaboration and the ability to influence provider and stakeholder decisions in complex situations.Proven track record of applying knowledge of competitor strategies, complex contracting models, and financial arrangements to support negotiations and achieve favorable contract outcomes while maintaining regulatory compliance.Working knowledge of Medicare programs and related regulatory and operational requirements.EducationBachelor's degree preferred or a combination of professional work experience and education.Anticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$60,300.00 - $132,600.00This 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.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.