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
Contracting
Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations focused on health systems in Indiana.
Manages contract performance
Contributes to provider compensation and pricing development activities and recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities.
May optimize interaction with assigned providers and internal business partners to manage 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.
Network Performance/Oversight
Recruits’ providers as needed to ensure attainment of network expansion and adequacy targets.
Responsible for identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities.
Assists with the design, development, management, and/or implementation of strategic network configurations
Required Qualifications
Must reside in Indiana
Minimum 7+ years related experience and comprehensive level of negotiating with individual or complex provider systems or groups.
Knowledge of Indiana provider systems and market landscape.
Required to communicate w/internal/external parties by phone/in person; minimal travel to offsite provider groups and/or health system locations
Related experience in health operations, network relations and development, command of financials and pricing strategies, and sales interface.
Experience building and maintaining relationships with provider systems.
A successful track record managing and negotiating major provider contracts (move up)
In depth knowledge of various reimbursement structures and payment methodologies for both hospitals and providers/providers.
Preferred Qualifications
Knowledge and experience with value-based contracting and accountable care models.
In-depth knowledge of managed care business, regulatory /legal requirements.
Medicare Advantage knowledge and experience
Education
Bachelor's degree preferred/specialized training/relevant professional qualification
Pay Range
The typical pay range for this role is:
$67,900.00 - $149,328.00
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.
Skills Required
- Minimum 7+ years related experience
- In-depth knowledge of various reimbursement structures and payment methodologies
- Knowledge of Indiana provider systems and market landscape
- Experience in health operations and network relations
- Bachelor's degree preferred
CVS Health Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about CVS Health and has not been reviewed or approved by CVS Health.
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Healthcare Strength — Healthcare coverage is positioned as comprehensive for benefits-eligible colleagues, including medical, dental, and vision with free preventive care and access to virtual care and select no-cost MinuteClinic services. Mental health support is also highlighted with no-cost confidential counseling sessions per issue.
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Retirement Support — Retirement benefits include a 401(k) with a dollar-for-dollar match up to 5% after meeting service and hours requirements. Ownership programs are also offered through an employee stock purchase plan with a stated purchase discount.
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Pay Growth & Progression — A companywide minimum wage floor establishes a baseline that is framed as a positive starting point in some roles and markets. Unionized or high-cost areas are described as having clearer wage scales and step-ups that can materially lift pay over time.
CVS Health Insights
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.
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