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Individual contributor role managing contract performance and driving the development and implementation of value-based contract relationships in support of business strategies for CVS Health, the nation's leading health solutions company.
Job Responsibility:
Manages contract performance and drives the development and implementation of value-based contract relationships
Recruits providers as needed to ensure attainment of network expansion and adequacy targets
Accountable for cost arrangements within defined groups
Collaborates cross-functionally to manage provider compensation and pricing development activities
Responsible for identifying and managing cost issues and collaborating cross functionally to execute significant cost saving initiatives
Represents company with high visibility constituents
Promotes collaboration with internal partners
Evaluates, helps formulate, and implements the provider network strategic plans
Ensures resolution of escalated issues related to claims payment, contract interpretation and parameters
Requirements:
3-5 years of related experience
Proven and proficient managed care network negotiating skills
Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills
Proven ability to negotiate and collaborate with providers and partners at all levels
Proven working knowledge of competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements
Highly organized and self-driven
Bachelor's degree and relevant training or work experience
Nice to have:
Ability to forge meaningful, long-lasting relationships with providers
Knowledge of Medicare programs and related subject matter
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