Contract Negotiation Manager

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

📋 Description

• Negotiate, execute, review, and analyze contracts while managing dispute resolution and settlement negotiations with solo practitioners, small groups, or local providers, including SCAs, LOAs, and PPAs.

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

• Recruit providers to meet targets for network expansion and adequacy.

• Collaborate across functions on provider compensation and pricing development, submission of contractual information, and negotiation and reimbursement modeling reports.

• Identify and propose actions to address cost issues and support initiatives for cost savings and settlements.

• Provide strategies and activities for network development, maintenance, and refinement to facilitate cross-market network management.

• Assist in the design, development, management, implementation, and integration of strategic network configurations.

• Enhance interactions with assigned providers and internal business partners to foster relationships and fulfill provider needs.

• Address escalated issues concerning claims payments, contract interpretation, contract parameters, and accuracy of provider contract or demographic information.

• Interpret contractual obligations, including federal and state regulations as well as NCQA standards.

⛳️ Requirements

• 5+ years of experience in the healthcare industry, encompassing knowledge of competitor strategies, complex contracting alternatives, financial arrangements, and regulatory requirements.

• 3+ years of experience in provider relationship management or related roles within healthcare.

• Demonstrated and competent contract management skills.

• Excellent communication, critical thinking, problem-solving, and interpersonal abilities.

• Proficiency in Microsoft Office Suite, including Excel, Word, PowerPoint, and Outlook.

• Candidates located on the West Coast are highly preferred.

• A Bachelor's degree is preferred, or an equivalent combination of professional experience and education.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources for supporting physical, emotional, and financial well-being.

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