Contract Negotiation Manager

This is a fully remote position, open to applicants in Ohio, +3 more states.

📋 Description

• Negotiate, execute, review, and analyze contracts with individual, small-group, or local providers.

• Manage provider dispute resolution and settlement negotiations.

• Oversee contract performance to align with network quality, availability, financial objectives, and strategies.

• Recruit providers to meet network expansion and adequacy targets.

• Collaborate on provider compensation, pricing development, contractual details, negotiation processes, and reimbursement modeling activities.

• Identify and propose solutions for cost-related issues and support initiatives aimed at cost savings and settlement activities.

• Conduct network development, maintenance, and refinement activities.

• Assist in strategic network configuration and integration efforts.

• Enhance interactions with assigned providers and internal business partners.

• Address escalated issues related to claims payments, contract interpretation, contract parameters, and provider contract or demographic details.

⛳️ Requirements

• At least 5 years of experience in negotiating contracts with ancillary providers, healthcare facilities, and physician groups.

• Proficient in contract language, development and analysis of rate proposals, identifying operational and financial improvement opportunities, and the collection and analysis of competitive data and key financial metrics.

• A minimum of 3 years of experience in provider relationship management or similar healthcare roles.

• Strong contract management skills.

• Knowledge of common contract provisions, provider reimbursement methodologies and terms, as well as industry-standard payment policies and practices.

• Understanding of provider financial challenges, regulatory requirements, and competitor strategies.

• High proficiency in Microsoft Office suite applications, including Outlook, Word, and Excel.

• Capability to build collaborative relationships with providers and work across functions to resolve complex provider contract issues.

• Ability to manage and prioritize multiple negotiations, issues, and tasks to meet deadlines.

• Experience with Commercial and Medicare lines of business is preferred.

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

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to base salary.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being, based on eligibility.