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.
- Entry level contracting role for a candidate with minimal contracting experience and background.
- Project management skills to prioritize competing priorities and effectively communicate provider contracting scenarios with attention to detail based on a thorough evaluation of provider data using internal tools.
- Manages contract performance and drives the development and implementation of value-based contract relationships in support of business strategies.
- Recruits providers as needed to ensure attainment of network expansion and adequacy targets. Accountable for cost arrangements within defined groups.
- 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.
- Responsible for identifying and managing cost issues and collaborating cross functionally to execute significant cost saving initiatives.
- Represents company with high visibility constituents, including customers and community groups. Promotes collaboration with internal partners.
- Evaluates, helps formulate, and implements the provider network strategic plans to achieve contracting targets and manage medical costs through effective provider contracting to meet state contract and product requirements. Collaborates with internal partners to assess effectiveness of tactical plan in managing costs.
- May optimize interaction with assigned providers and internal business partners to facilitate relationships and ensure provider needs are met. Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information.
Required Qualifications
5+ years experience in a provider relations, contracting or managed care environment
Knowledge of the managed care industry and practices, as well as a strong understanding of strategies, practices, and financial/contracting arrangements.
Must possess critical thinking, problem resolution, organizational and interpersonal skills.
Highly organized and self-driven
Must reside in Georgia and able to drive into the Atlanta office location 1x per month
Preferred Qualifications
Ability to forge meaningful, long-lasting relationships with providers.
Physician, Ancillary and/or Commercial experience
Knowledge of Medicare programs and related subject matter
Education
- Bachelor’s degree and relevant training or work experience
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$54,300.00 - $119,340.00This 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.
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.
Skills Required
- 5+ years experience in a provider relations, contracting or managed care environment
- Knowledge of the managed care industry, practices, and financial/contracting arrangements
- Project management skills to prioritize competing priorities and communicate provider contracting scenarios
- Critical thinking, problem resolution, organizational and interpersonal skills
- Highly organized and self-driven
- Must reside in Georgia and able to drive into the Atlanta office location 1x per month
- Bachelor's degree and relevant training or work experience
What We Do
CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners. Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.
