Provider Network Contracting Senior Manager (MO, IL)

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. Ideal candidate will sit in Central or Eastern Time Zone The Senior Manager negotiates, executes, conducts high level review and analysis, dispute resolution and/or settlement negotiations of contracts. Works with larger and more complex, market/regional/national based groups/systems in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals and cost initiatives. The Senior Manager will be responsible for contracting and implementing fee for service and value-based agreements with key physician groups, facilities, and ancillary providers to support commercial and individual exchange networks. This person will also work collaboratively with Aetna and CVS departments to identify initiatives to improve physician performance and quality of care provided to our members. 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. Required Qualifications Minimum 7 years related experience and comprehensive level of negotiating with individual or complex provider systems or groups. Proven working knowledge of provider financial issues and competitor strategies, large/complex contracting options, financial/contracting arrangements, and regulatory requirements. Strong communication, critical thinking, problem resolution and interpersonal skills. Preferred Qualifications Commercial, individual exchange and Medicare experience. Experience contracting with hospital systems and groups. Advanced Excel experience including pivot tables and v‑lookup function. Education Bachelor’s Degree preferred or equivalent combination of education and professional work experience. Pay Range The typical pay range for this role is: $67,900.00 - $182,549.00. This range represents the base hourly rate or base annual full-time salary. The actual base salary will depend on experience, education, geography and other factors. The position is eligible for additional incentives such as bonus, commission or short-term incentive program and an 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. Benefits include medical, dental, and vision coverage; paid time off; retirement savings options; wellness programs; and other resources. Additional benefits information will be provided during the application process. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. #J-18808-Ljbffr 4062 Aetna Resources, LLC