Manager, Behavioral Health
Imagine PediatricsSalary not specified
Full Time
Senior (5 to 8 years)
Senior Manager, Network Management Behavioral Health (Southern CA, MT) at CVS Health
California, Kentucky, United States
Not SpecifiedCompensation
Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level
Full TimeJob Type
UnknownVisa
HealthcareIndustries
Requirements
- 5+ years related experience and comprehensive level of negotiating skills with successful track record negotiating contracts, including fee schedules, with individual or complex provider systems or groups
- Focus on behavioral health providers and facility types
- Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements
- Strong communication, critical thinking, problem resolution and interpersonal skills
- Experience in provider relations activities including claims issue resolution, adding new locations, general provider data maintenance and contract amendments
- Bachelor's Degree or equivalent combination of education and experience
Responsibilities
- Negotiates, executes, conducts high level review and analysis, dispute resolution and/or settlement negotiations of behavioral health facility and hospital contracts with larger and more complex, market/regional/national based group/system providers
- Maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals and cost initiatives in accordance with company standards
Skills
Key technologies and capabilities for this role
Questions & Answers
Common questions about this position
What is the pay range for this Senior Manager role?
The typical pay range is $67,900.00 - $199,144.00, depending on factors like experience, education, and geography. The position is also eligible for a bonus, commission, short-term incentive program, and company equity award.
Is this position remote or does it require a specific location?
Preferred candidates reside in the Pacific or Mountain time zones, with the role focused on Southern CA and MT. This information is not specified in the job description.
What skills and experience are required for this role?
Requires 5+ years of related experience with a track record in negotiating contracts, focus on behavioral health providers, knowledge of provider financial issues and regulations, plus strong communication, critical thinking, problem resolution, and interpersonal skills.
What is the company culture like at CVS Health?
CVS Health fosters a workplace with dedicated, purpose-driven colleagues passionate about transforming health care, reflecting the customers, patients, and communities served, where every colleague feels valued.
What makes a strong candidate for this position?
Strong candidates have 5+ years negotiating behavioral health contracts, knowledge of financial and regulatory issues, plus preferred experience in West coast states, compliance activities, and commercial/Medicare/Medicaid lines.
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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