Senior Provider Network Contractor, CVS Health

CVS Health

Location:
United States, Work at Home, Washington

Category:
Health and Beauty

Contract Type:
Employment contract

Salary:

75400.00 - 182549.00 USD / Year

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Job Description:

The Senior Manager negotiates, executes, conducts high-level review and analysis, dispute resolution, and/or settlement negotiations of contracts while working with large and complex provider networks. Responsible for contracting fee-for-service and value-based agreements with key physician groups, facilities, and ancillary providers. Recruits providers to meet network adequacy goals, collaborates on provider compensation and pricing activities, and engages in reimbursement modeling

Job Responsibility:

Negotiates, executes, conducts high-level review and analysis, dispute resolution, and/or settlement negotiations of contracts
Works with larger and more complex, market/regional/national-based groups/systems in accordance with company standards
Responsible for contracting and implementing fee-for-service and value-based agreements with key physician groups, facilities, and ancillary providers
Recruits providers as needed to ensure attainment of network expansion and adequacy targets
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

Requirements:

Minimum 5 years related experience and comprehensive level of negotiating with individual or complex provider systems or groups
Proven working knowledge of provider financial issues and competitor strategies, large/complex contracting options, financial/contracting arrangements, and regulatory requirements
Strong communication, critical thinking, problem resolution, and interpersonal skills

Nice to have:

Commercial, individual exchange, and Medicare experience
Experience contracting with hospital systems and groups
Advanced Excel experience including pivot tables and v-lookup function

What we offer:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Benefit solutions including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access

Additional Information:

Job Posted:
August 02, 2025

Expiration:
August 30, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Senior Provider Network Contractor