Work At Home-Arizona, United States of America
Remote only
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Position Summary
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 in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals and cost initiatives.
*Focus on behavioral health provider and facility types.
Required Qualifications
- 5-7+ years related experience and comprehensive level of negotiating skills with successful track record negotiating contracts, including fee schedules, with individual or complex provider systems or groups
- Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements
- Strong communication, critical thinking, problem resolution and interpersonal skills
- Experience in provider relations activities including claims issue resolution, adding new locations, general provider data maintenance and contract amendments
Preferred Qualifications
- Candidates residing in the Pacific or Mountain time zones
-Behavioral Health Provider contract experience
- Experience supporting compliance/regulatory activities including network adequacy reporting, network gap mitigation activities and market expansions. Experience should include reviewing state bulletins, billing guides, etc.
- Previous experience in West coast region states a plus
- Experience in commercial, Medicare and Medicaid lines of business ideal
Education
Bachelor's Degree or equivalent combination of education and experience
Pay Range
The typical pay range for this role is:
$75,400.00 - $182,549.00
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.
Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Great benefits for great people
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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