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CVS Health

Senior Manager, Value Based Care Network Contracting (New York/New Jersey)

1 week ago• Dover, DE

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.This is an individual contributor role

Position Summary

The Sr. Manager, Value-based Contracting is responsible for establishing and maintaining productive value-based relationships with key network providers. Supports the NY/NJ Value-based Network as outlined below:

  • Accountable for building strategic relationships with our provider partners to develop innovative value-based solutions to meet total cost and quality goals.
  • Responsible for negotiating high value/risk contracts with complex arrangement structures, which requires:

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  • understanding providers' volume and cost structure
  • working cross functionally to identify the levers and critical negotiation points
  • aligning negotiation strategies and tactics with network accessibility, quality, compliance and financial performance goals
  • Supports the complete value based contracting cycle from planning, creating documents, negotiation and loading of executed arrangements.
  • Works with Performance Team, Clinical Transformation Team, VBS Analytics team and other key internal teams to implement the value based strategic plan and oversee contract performance with targeted provider groups to ensure we meet guidelines for value based provider agreements.
  • Helps formulate and implement network strategic plans to achieve value-based contracting targets and manage medical costs through effective value-based contracting.
  • Provides assistance and support to other departments, as needed, to obtain crucial or required information from providers, such as HEDIS, Credentialing, Grievance and Appeals, SIU, etc. Coordinates provider status information with member services and other internal departments.
  • Leads work and deliverables of multiple projects/programs, through assessment to implementation, that impact multiple processes, systems, functions, and products across all lines of business.
  • Facilitates and attends external provider meetings and negotiations, as needed.
    • Required Qualifications
    • 7+ years of related experience and comprehensive level of negotiating skills with successful track record negotiating value-based contracts
    • Experience reviewing medical claims data and identifying opportunities for mitigating medical cost trend
    • Excellent analytical and problem-solving skills
    • Strong communication, negotiation, and presentation skills
    • Ability to work in a matrixed organization and gain consensus and share information to various interested parties.
    Preferred Qualifications
    • Familiar with legal terms in the context of provider contracting
    • Experience with Commercial and Medicare contracting
    • Strong financial modeling background
    • Resident of New York, New Jersey or Pennsylvania preferred
    Education
    • Bachelor Degree preferred or a combination or professional work experience and education.
    Pay Range

    The typical pay range for this role is:$75,400.00 - $199,144.00

    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.
    For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 10/18/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

    Client-provided location(s): Dover, DE
    Job ID: CVS-R0689226_1002
    Employment Type: FULL_TIME
    Posted: 2025-09-18T19:44:25

    Perks and Benefits

    • Health and Wellness

      • Health Insurance
      • Dental Insurance
      • Vision Insurance
      • Life Insurance
      • HSA
      • HSA With Employer Contribution
      • Pet Insurance
      • Mental Health Benefits

    • Parental Benefits

      • Fertility Benefits
      • Adoption Assistance Program
      • Family Support Resources

    • Work Flexibility

      • Flexible Work Hours
      • Remote Work Opportunities
      • Hybrid Work Opportunities

    • Office Life and Perks

      • Vacation and Time Off

        • Paid Vacation
        • Paid Holidays
        • Personal/Sick Days

      • Financial and Retirement

        • 401(K) With Company Matching

      • Professional Development

        • Tuition Reimbursement

      • Diversity and Inclusion

        • Employee Resource Groups (ERG)
        • Diversity, Equity, and Inclusion Program