Description
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. Thank you for your interest in furthering your career with CVS Health. This site is dedicated to hosting all CVS Health openings across the enterprise, and is only available to our internal colleagues. Here you can search openings, maintain your internal candidate profile, upload resumes, and set up a search agent for newly posted jobs that match your search criteria. We encourage you to discuss your career goals and interest in a new role with your leader. Should you be considered for a new role, a notification will be sent to your current leader during the selection process. Note: If you are a contractor or external consultant and have reached this page, please logout of this internal employee Career Site and apply via the CVS Careers Page. *Position Summary:* Do you want to make a large impact in your next role? Join Aetna/CVS Health, a Fortune 4 company, as the Network Management Senior Manager. In this role, you will manage negotiations, conduct high-level reviews and analysis, and manage dispute resolution and settlement negotiations of contracts, with large and complex, national, and market-based, behavioral health groups and facility providers. You will manage contract performance and support the development and implementation of strategic, traditional contracts and value-based relationships. * Recruit large scale and/or innovative providers as needed to ensure attainment of network expansion and strategic targets. *Initiates, coordinates, and own the contracting activities to fulfillment including receipt and processing of contracts and documentation and pre and post signature review of contracts and language modification according to Aetna's established policies. *Responsible for auditing, building, and loading contracts, amendments and/or fee schedules in accordance with Aetna's established systems and policies. *Conducts research, analysis and/or audits to identify issues and propose solutions to protect data, contract integrity and performance. *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 Expert support for questions related to recruitment initiatives, contracting, provider issues/resolution *Provide guidance and share expertise to others on the team *Manage high level projects and recruitment initiatives with interdepartmental resources and/or cross functionally *Supports or assists with operations activities that may include, but not limited to, database management and contract coordination **Organizing and transforming information into comprehensible structures. using data to predict trends and put into practice *Performing statistical analysis of data *Preparing reports and presenting these to leadership *Engage with providers and quickly move the providers through contracting processes in order to ensure meeting turnaround time requirements. *Negotiate complex contracts within assigned territory *Focus on behavioral health provider and facility types. *Behavioral health facility contracting background *Required Qualifications* *5-10 years of network contracting and management experience *5+ years of proven knowledge of standard provider contracts, terms and language desired *5+ years of solid negotiating and decision-making skills while executing national, regional, or market level strategies *In-depth knowledge of the managed care industry and practices, as well as a strong understanding of Aetna competitor strategies, practices, and financial/contracting arrangements *Demonstrated high proficiency with Excel *Ability to work independently and as part of a team * Ability to travel as needed (up to 25% travel). *Must be located in MI, MN or PA. *Preferred Qualifications* *Solid decision making skills while executing regional and market level strategies *Ability to forge long-term relationships with providers *Possess critical thinking, problem resolution and interpersonal skills *Background in behavioral health contracting preferred * Ability to identify and capitalize on opportunities to support program delivery. * Communication Skills - Strong communication skills (written, verbal and presentation). * Highly organized and self-driven. *Education* Minimum Bachelor's degree or equivalent experience. Master degree preferred. *Pay Range* The typical pay range for this role is: $75,400.00 - $174,200.00 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. 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](https://jobs.cvshealth.com/benefits) We anticipate the application window for this opening will close on: 07/15/2024
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