Senior Network Contracting Negotiation Manager

This is a fully remote position, open to applicants in Michigan.

📋 Description

• Negotiate intricate network contracts with healthcare providers, setting reimbursement rates, service agreements, and performance metrics.

• Offer guidance on provider performance, network adequacy, geographic coverage, and member satisfaction.

• Execute necessary modifications or expansions to the network.

• Implement initiatives for improvement to ensure that network providers comply with regulatory and quality standards.

• Develop and enlarge the network by identifying and contracting with hospitals, physicians, specialists, and ancillary service providers.

• Conduct market analysis and evaluate competitive positioning.

• Propose strategies to maintain a competitive advantage.

• Collaborate with finance on budgeting, cost analysis, and financial forecasting.

• Oversee the financial elements of provider network management.

• Consult with medical directors, operations managers, and network development professionals to align performance objectives.

• Continuously provide recommendations to senior leadership to inform decision-making and align with strategic objectives.

⛳️ Requirements

• A minimum of 7 years of experience in the healthcare industry.

• At least 5 years of related experience.

• Extensive provider negotiation skills with a proven success record in negotiating contracts with complex provider systems or groups.

• Must be a resident of Michigan.

• Strong critical thinking skills to maintain cost management and a fully engaged network of participating hospitals, ancillaries, and providers.

• Proficiency in Microsoft Office and Excel.

• Willingness to travel within the assigned Michigan market up to 10–15% of the time as required.

• Experience with contract management systems is preferred.

• Relevant experience and knowledge of the local healthcare market and payer dynamics are preferred.

• Demonstrated analytical skills with a proven ability to troubleshoot complex issues are preferred.

• Ability to connect data to daily task execution is preferred.

• Bachelor’s Degree or equivalent professional work experience.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program.

• Target award in the company’s equity award program.

• 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.