At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary
Provides strategic leadership and oversight for network management and provider relations. Develops and implements network strategies, manages provider contracts and negotiations, monitors provider performance metrics, leads dispute resolution processes, and collaborates with key stakeholders to drive network growth and ensure high-quality provider relationships A Brief Overview
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Provides strategic leadership and oversight for network management and provider relations. Develops and implements network strategies, manages provider contracts and negotiations, monitors provider performance metrics, leads dispute resolution processes, and collaborates with key stakeholders to drive network growth and ensure high-quality provider relationships.
What you will do
- Oversees key Network Management contracting activities, including negotiating fee schedules, reimbursement rates, and contract terms and conditions.
- Controls the development and expansion of the company's provider network by evaluating potential network providers, negotiating contracts, and establishing relationships with healthcare providers to ensure a comprehensive and high-quality network.
- Contributes to optimizing the network's performance and effectiveness by analyzing network data, utilization patterns, and market trends to identify opportunities for network enhancements, cost savings, and improved access to care.
- Manages the performance of network providers, including tracking key performance indicators, analyzing provider performance data, and implementing performance improvement initiatives.
- Conducts market analysis, assesses competitive landscapes, and makes recommendations for network expansion strategies.
- Develops training sessions and communicates updates related to network management, utilization management, claims processing, and other relevant topics.
- Communicates findings to executive leadership and stakeholders, identifying opportunities for improvement and cost containment.
- Manages operational aspects of the team, subsequently implementing workforce and succession plans to meet business goals and objectives.
- Guides management for individual performance evaluations aimed to provide critical feedback for skills development and depth of work area experience.
- A minimum of 10 years professional work experience in provider network management.
- A minimum of 3 years in a management role leading others.
- Must have experience with both fee for service and value-based care contracting.
- Adept at execution and delivery (planning, delivering, and supporting) skills
- Adept at business intelligence
- Adept at collaboration and teamwork
- Mastery of problem solving and decision making skills
- Mastery of growth mindset (agility and developing yourself and others) skills
- Strong analytical skills and operating system efficiency .
- Bachelor's degree preferred or a combination of professional work experience and education.
The typical pay range for this role is:$100,000.00 - $231,540.00
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 peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
- 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 that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.