Provider Contract Negotiation Manager (Pacific Northwest)
- OREGON EMPLOYMENT DEPARTMENT
- Salem, Massachusetts
- Full Time
Job Listing ID: 4283624 Job Title: Provider Contract Negotiation Manager (Pacific Northwest)
Application Deadline: Open Until FilledJob Location: Salem
Date Posted: 06/03/2025Hours Worked Per Week: Not Provided
Shift: Not Provided
Duration of Job: Either Full or Part Time, more than 6 months
You may contact this employer directly.
(Obtain the contact information to print or add to your jobs.)
Job Summary:
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
The Contract Negotiation Manager position negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with solo, small group, or local providers. Manages contract performance in support of network quality, availability, and financial goals and strategies.
Recruits providers as needed to ensure attainment of network expansion goals, achieve regulatory and/or internal adequacy targets.
Collaborates cross-functionally to contribute 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.
Provides Subject Matter Expert support for questions related to recruitment initiatives, contracting, provider issues/resolutions, related systems and information contained
Provide guidance and share expertise to others on the team
Responsible for identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities. Provides network development, maintenance, and refinement activities and strategies in support of cross-market network management unit.
Assists with the design, development, management, and or implementation of strategic network configurations, including integration 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.
Required Qualifications
3+ years related experience, proven and proficient negotiating skills.
Proven working knowledge of competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements.
Must reside in the Pacific Northwest market (Washington, Oregon, Alaska, or Idaho)
In-depth 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 and interpersonal skills
Highly organized and self-driven
Preferred Qualifications
Ability to forge meaningful, long-lasting relationships with providers
Knowledge of Medicare programs and related subject matter
Education
Bachelor's degree preferred
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$54,300.00 - $145,860.00
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.
Our people fuel our future. O...
Job Classification: Business Operations Specialists, All Other
Access our statewide or regional occupation report for more information about wages,
employment outlooks, skills, training programs, related occupations, and more.
Compensation
Salary: Not Provided
Job Requirements
Experience Required: See Job Summary
Education Required: NoneMinimum Age: N/A
Gender: N/A
Application Deadline: Open Until FilledJob Location: Salem
Date Posted: 06/03/2025Hours Worked Per Week: Not Provided
Shift: Not Provided
Duration of Job: Either Full or Part Time, more than 6 months
You may contact this employer directly.
(Obtain the contact information to print or add to your jobs.)
Job Summary:
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
The Contract Negotiation Manager position negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with solo, small group, or local providers. Manages contract performance in support of network quality, availability, and financial goals and strategies.
Recruits providers as needed to ensure attainment of network expansion goals, achieve regulatory and/or internal adequacy targets.
Collaborates cross-functionally to contribute 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.
Provides Subject Matter Expert support for questions related to recruitment initiatives, contracting, provider issues/resolutions, related systems and information contained
Provide guidance and share expertise to others on the team
Responsible for identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities. Provides network development, maintenance, and refinement activities and strategies in support of cross-market network management unit.
Assists with the design, development, management, and or implementation of strategic network configurations, including integration 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.
Required Qualifications
3+ years related experience, proven and proficient negotiating skills.
Proven working knowledge of competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements.
Must reside in the Pacific Northwest market (Washington, Oregon, Alaska, or Idaho)
In-depth 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 and interpersonal skills
Highly organized and self-driven
Preferred Qualifications
Ability to forge meaningful, long-lasting relationships with providers
Knowledge of Medicare programs and related subject matter
Education
Bachelor's degree preferred
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$54,300.00 - $145,860.00
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.
Our people fuel our future. O...
Job Classification: Business Operations Specialists, All Other
Access our statewide or regional occupation report for more information about wages,
employment outlooks, skills, training programs, related occupations, and more.
Compensation
Salary: Not Provided
Job Requirements
Experience Required: See Job Summary
Education Required: NoneMinimum Age: N/A
Gender: N/A
Job ID: 479906591
Originally Posted on: 6/5/2025
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