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
Acts as the primary resource for an assigned profile of providers (i.e., market/ regional/ national, large group or hospital systems) to, oversee, and maintain provider risk management and positive relationships in support of high value initiatives. Drives the implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets. Manages provider contracting intake process which includes audit and oversight of audit resources of all provider contract/credentialing materials received from provider, provider outreach which may include moderate contracting negotiation activities as well as research and analysis to inform solutions, close gaps and maximize the provider network. Lead a team of Network Development Auditors responsible for reviewing and assessing provider contracting and credentialing documents.

Required Qualifications

• 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 attention to detail, use of consistent processes / business standards, and overall project management skills

• Manages provider contracting intake process which includes audit and oversight of audit resources of all provider contract/credentialing materials received from provider. Provider outreach which may include moderate contract negotiations activities as well as research and analysis to inform solutions, close gaps and maximize the provider network.

• A minimum of 3 years' experience Medicaid servicing or managing relationships with providers with exposure to benefit plan design and/or contract interpretation.

• Working knowledge of Medicaid specific codes, products, and terminology.

• At least 1 year of experience supervising or managing a production-oriented team.

Preferred Qualifications

• Proven advanced problem-solving skills, proven independent worker and self-starter.

• Demonstration of meeting leadership skills and meeting management.

• Demonstration of experiential or educational project management skills.

• Ability to evaluate data and identify action plans or solutions based on data.

• Ability to handle conflict management.

• Ability to educate an outcome or position even if unfavorable.

Education

• Bachelor’s Degree or equivalent combination of education and experience

Pay Range

The typical pay range for this role is:

$54,300.00 – $139,200.00

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.

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: 08/30/2024

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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