CVS Health is looking for a Senior Provider Network Contractor to join our team in the Pacific Northwest. In this role, you will negotiate, execute, review, and analyze contracts with large and complex provider systems. You will be responsible for contracting fee-for-service and value-based agreements with physician groups, facilities, and ancillary providers to support our commercial and individual exchange networks, while recruiting providers to ensure network expansion and adequacy targets are met.
What You'll Do
- Negotiate, execute, conduct high-level review and analysis, and manage dispute resolution and settlement negotiations of contracts.
- Work with larger and more complex, market/regional/national based groups and systems to maintain and enhance provider networks.
- Contract and implement fee-for-service and value-based agreements with key physician groups, facilities, and ancillary providers.
- Work collaboratively with Aetna and CVS departments to identify initiatives to improve physician performance and quality of care.
- Recruit providers as needed to ensure attainment of network expansion and adequacy targets.
- Manage provider compensation and pricing development activities, submission of contractual information, and review and analysis of reports.
- Collaborate cross-functionally on reimbursement modeling activities.
What We're Looking For
- Minimum of 5 years related experience and comprehensive level of negotiating with individual or complex provider systems or groups.
- Proven working knowledge of provider financial issues and competitor strategies.
- Proven working knowledge of large/complex contracting options, financial/contracting arrangements, and regulatory requirements.
- Strong communication, critical thinking, problem resolution and interpersonal skills.
Nice to Have
- Commercial, individual exchange and Medicare experience.
- Experience contracting with hospital systems and groups.
- Advanced Excel experience including pivot tables and v-lookup function.
- Bachelor’s Degree preferred or equivalent combination of education and professional work experience.
Technical Stack
- Advanced Excel
Team & Environment
Works collaboratively with Aetna and CVS departments.
Benefits & Compensation
- Affordable medical plan options.
- 401(k) plan with matching company contributions.
- Employee stock purchase plan.
- No-cost wellness screenings, tobacco cessation and weight management programs.
- No-cost confidential counseling and financial coaching.
- Paid time off.
- Flexible work schedules.
- Family leave.
- Dependent care resources.
- Colleague assistance programs.
- Tuition assistance.
- Retiree medical access.
- Compensation range: $75,400.00 - $182,549.00 + equity: Award target in the company’s equity award program.
Work Mode
This position is local-country, based in Washington or Oregon.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
