Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

Position Summary
Negotiate and execute ancillary contracts, conducts high level review and analysis, engages in dispute resolution and/or settlement negotiations of contracts with larger and more complex, market / regional / national based ancillary providers in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, quality, and financial goals and cost initiatives. Problem solving skills that will assist with Contract and Claims issues in Aetna Systems.

Required Qualifications

-Minimum 4+ years related experience and expert level negotiation skills with successful track record negotiating contracts with large or complex national providers.

– Experience with provider contracts, contracting options, system loads as well as provider configurations.
– In-depth knowledge of the managed care industry, as well as a strong understanding of competitor strategies, practices and financial/contracting arrangements.
– Strong written and verbal communication skills and ability to identify and capitalize on marketing opportunities to support program delivery.
– Attention to detail; ability to analyze, identify and report on significant changes to network adequacy for Commercial, High Performance Plan and Medicare plans

– Work collaboratively with multiple business areas.
– Exceptional Customer Service Skills.

Preferred Qualifications
– Reside in Midwest or East Coast time zones (any location)

– Experience with Risk Arrangements (VBC).

– Knowledge of ACAS, EPDB (Enterprise Provider Database), HRP (Health Rules Payor), Financial Report Model and SCM (Strategic Contract Manager)

– Knowledge of Medicare Payment Systems including P4P (Pay for Performance) arrangements.

Education

– Bachelor's degree preferred/specialized training/relevant professional qualification

Pay Range

The typical pay range for this role is:

$75,400.00 – $199,144.80

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 09/08/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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