Senior Manager, Medicaid Network Management, CVS Health

CVS Health

Location:
United States, Work at Home

Category:
Health and Beauty

Contract Type:
Employment contract

Salary:

82940.00 - 182549.00 USD / Year

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Job Description:

Negotiates, executes, conducts high level review and analysis, dispute resolution and/or settlement negotiations of contracts with larger and more complex, market-based group/system providers in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals and cost initiatives.

Job Responsibility:

Negotiates, executes, conducts high level review and analysis, dispute resolution and/or settlement negotiations of contracts with larger and more complex, market-based group/system providers
Analyzes market needs and opportunities for network expansion, identifies gaps in the existing network, and proactively seeks new provider relationships
Ensures governance with healthcare regulations and contractual requirements
Initiates moderate and/or complex contracting activities, including collection of required contract and credentialing documents
Collaborates on negotiations or may handle contracting and re-contracting discussions with providers, provider groups and/or health systems
May participate in various internal and/or external meetings, serving as representative on behalf of the department
Supports or assists with operational activities including database management and contract coordination
Provides ongoing recommendations to leadership to guide decision-making
Coaches and mentors more junior level colleagues in contracting techniques, processes and responsibilities

Requirements:

7+ years related experience and expert level negotiation skills with successful track record negotiating contracts with large or complex provider systems
Strong communication, critical thinking, problem resolution and interpersonal skills
Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, financial/contracting arrangements and regulatory requirements
Medicaid Network Management experience, preferably Maryland Medicaid program
Residing within the state of Maryland highly preferred, will consider other locations within the DMV area
Bachelor's Degree preferred or relevant professional experience

Nice to have:

Medicaid Network Management experience with Maryland Medicaid program
Residing within the state of Maryland

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
No-cost wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
October 11, 2025

Expiration:
October 31, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Senior Manager, Medicaid Network Management