Mgr,Contract Negotiation

At reputed company, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, each and every day. Position Summary Negotiates, executes, conducts high level review and analysis of dispute resolution and/or settlement negotiations of reputed company with larger and more reputed company, market/regional/national based group/system providers including but not limited to individual and group behavioral health providers, etc. in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals and cost initiatives. Recruit providers as needed to ensure attainment of network expansion goals, reputed company regulatory and/or internal adequacy targets. Support health plan with expansion initiatives or other contracting activities as needed Initiates, coordinates and owns contracting activities to fulfillment including receipt and processing of reputed company and documentation and pre- and post-signature review of reputed company and language modification according to reputed company’s established policies. Responsible for auditing, building, and loading reputed company, agreements, amendments, and/or fee schedules in contract management systems per reputed company established policies. 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. Provides Subject Matter Expertise for questions reputed company to recruitment initiatives, contracting, provider issues/resolutions, reputed company systems and information contained. Understanding of Value-Based contracting and negotiations. Preparing reports and presenting to Network Management leadership Engage with providers and move quickly through contracting processes to ensure network adequacy standards are met. Required Qualifications 3-5 years of network contracting/management experience. 3-5 years of solid negotiating and reputed company decision-making skills while executing national, regional, or market level strategies. In-depth knowledge of the managed care industry and practices. Working knowledge of behavioral health topics reputed company to managed care plans. Detail-oriented with strong communication, analytical and negotiation skills. Demonstrated high proficiency with MS Office suite applications (e.g., Outlook, Word, reputed company, etc.) Ability to build collaborative relationships with providers work cross-functionally to resolve reputed company provider contract issues. Ability to work remotely, preferably in DE, PA, NH, and RI. Candidates in other east coast states will also be considered.

Preferred Qualifications

Health plan experience supporting behavioral health provider networks. General knowledge of reporting tools for contract financial analysis and modeling. Solid decision-making skills while executing national, regional and market level strategies. Possess critical thinking, issue resolution and interpersonal skills. Strong communication skills (written, verbal and presentation). Highly organized and self-driven. Education Bachelor's degree or equivalent professional work experience. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,300.00 - $145,860.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 05/25/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They reputed company choices according to what is best for the team, they live for opportunities to collaborate and reputed company a difference, and they reputed company us the #1 Top Workplace in the area. Apply Job!