Senior Manager in Network Management – CVS Remote Jobs

Job Type: Senior Manager in Network Management from home
Location: California work from home
Company: CVS Health

Responsibilities:

In order to maintain and improve provider networks while exceeding accessibility, quality, and financial goals and cost initiatives, the Senior Manager of Network negotiates, executes, conducts high level review and analysis, dispute resolution and/or settlement negotiations of contracts with larger and more complex market/regional/national based group/system providers. Contracts with larger and more complicated market-based group/system suppliers are negotiated and executed, as well as high level assessment and analysis, dispute resolution, and/or settlement negotiations are carried out. In order to support company initiatives, manages contract performance and aids in the creation and execution of value-based contract partnerships. appoints providers as necessary to guarantee that the network expansion and sufficiency goals are met. responsible for cost agreements amongst predetermined groupings. In order to manage provider compensation and pricing development activities, contractual information submission, report evaluation and analysis as part of negotiation and reimbursement modeling operations, cross-functional collaboration is used. Initiating suitable cost-saving efforts and/or settlement activities, as well as recognizing and managing cost concerns. serves as SME for internal partners and less experienced team members. provides cross-market network management unit with activities and strategies for network creation, maintenance, and improvement. helps with the planning, creation, administration, and/or execution of strategic network configuration and integration tasks. To manage relationships and make sure provider needs are satisfied, interactions with assigned providers and internal business partners may be optimized. Ensures the resolution of escalated issues including, but not limited to, those relating to the payment of claims, the interpretation and application of contract terms, or the veracity of provider contracts or demographic data.

Pay Scale

The usual pay scale for this position is as follows:

• Lowest: 75,400
• Up to: 158,300

Please remember that this range represents the salary range for every position in the job grade that this position belongs to. The location is just one of several variables that will be considered when determining the actual compensation offer.

Requirements:

Required credentials

This position is for an individual contributor.

• Demonstrable expertise in complex contracting choices, financial/contractual arrangements, and regulatory requirements, as well as provider
• Financial concerns and competition strategies.
• 5-7 years of relevant expertise, a high degree of negotiation proficiency, and a proven track record of success when negotiating contracts with Single providers or complicated provider systems or groups.
• Strong interpersonal, problem-solving, critical thinking, and communication abilities.
• knowledge of the market in Northern California.
• Travel of up to 20% might be necessary.

Preferred Requirements

• Preferable knowledge of value-based contracting and individual exchange.
• This role should ideally be located in the North California region due to company requirements.

Education: Bachelor’s degree or a similar level of expertise