FREE ACCESS
5,000–10,000 jobs/day
See all jobs on Scoutfield
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Senior Manager, National Network Management – National Health Systems
CVS Health. Manage negotiation and development of contracts with larger and more complex national or regional-based providers and health systems .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates extensive expertise in negotiating high-value contracts with complex health systems, managing provider relationships, and implementing strategic network initiatives. Possesses strong analytical and critical thinking skills to optimize cost management and ensure compliance with regulatory requirements.
Highest-signal resume keywords
Expert-Level Negotiation ExperienceHealthcare Industry ExperienceValue-Based Contracting KnowledgeContractual Requirement InterpretationCritical Thinking and Problem Resolution
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Contract NegotiationContract Review and AnalysisCost ManagementProvider Compensation DevelopmentReimbursement ModelingContract Performance ManagementDispute ResolutionStrategic PlanningFinancial Contracting ArrangementsRegulatory Compliance
Soft Skills
Strong Communication SkillsInterpersonal SkillsCritical ThinkingProblem Resolution
Tools & Technologies
Internal Aetna System Knowledge
Industry Keywords
Healthcare PayerHealthcare ProviderNational Network StrategiesProvider Financial IssuesNCQA Compliance
About the role
Key responsibilities & impact- Manage negotiation and development of contracts with larger and more complex national or regional-based providers and health systems
- Design conceptual models and plan initiatives
- Negotiate high-value/high-risk contracts
- Conduct high-level contract review and analysis
- Participate in dispute resolution and settlement negotiations
- Manage contract performance
- Support development and implementation of strategic provider networks
- Support value-based contract relationships
- Identify and manage cost issues and initiate cross-functional cost-saving or settlement activities
- Collaborate cross-functionally on provider compensation, pricing development, contractual information, and reimbursement modeling
- Represent the company with high-visibility constituents, including customers and community groups
- Optimize interactions with assigned providers and internal business partners
- Facilitate JOC meetings
- Manage complex contractual provider relationships in support of national and regional network strategies
- Serve as a subject matter expert for less experienced team members and internal partners
- Resolve escalated issues involving claims payment, contract interpretation, and provider contract or demographic information
- Evaluate, formulate, and implement national network strategic plans to achieve contracting targets and manage medical costs
Requirements
What you’ll need- Minimum of 7 years of related experience
- Minimum of 5 years of successful expert-level negotiation experience with large or complex health systems
- Comprehensive negotiation skills and successful track record negotiating contracts with individual or complex provider systems or groups
- Critical thinking to maintain cost management and a fully engaged network of participating hospitals, ancillaries and providers
- Healthcare industry experience with either a payer or provider
- Strong communication, critical thinking, problem resolution and interpersonal skills
- Working knowledge of value-based contracting
- Internal Aetna system knowledge
- Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, financial/contracting arrangements and regulatory requirements
- Bachelor's degree preferred or a combination of equivalent work experience and education
- Ability to interpret contractual requirements including federal and state regulations and NCQA
Benefits
Comp & perks- CVS Health bonus, commission or short-term incentive program
- Equity award program
- Medical coverage
- Dental coverage
- Vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
- Other resources supporting physical, emotional, and financial well-being