[Remote] Contract Negotiation Manager - Indiana at CVS Health

India

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Not SpecifiedCompensation

Mid-level (3 to 4 years), Senior (5 to 8 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

3-5 years of related experience, proven and proficient managed care network negotiating skills
Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills with proven ability to influence and collaborate with providers and partners at all levels
Strong knowledge and experience in problem-solving techniques
Bachelor's degree or equivalent professional work experience
Strong preference for candidates residing in the state of Indiana

Responsibilities

Manages contract performance, and drives the development and implementation of contract relationships in support of business strategies
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
Identifies and manages cost issues and collaborates cross-functionally to execute significant cost saving initiatives
Represents company with providers, groups and health systems
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
Optimizes interaction with assigned providers and internal business partners to facilitate relationships and ensure provider needs are met
Ensures resolution of escalated issues related to claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information

Skills

Contract Negotiation

Provider Contracting

Contract Management

Network Expansion

Cost Management

Reimbursement Modeling

Provider Relations

Strategic Planning

Cross-Functional Collaboration

Claims Payment Resolution

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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