Manager, Contract Negotiations (Louisiana Medicaid)
- Salary
- $54.3K–$119.3K
- Hiring from
- United States
- Work type
- Hybrid
- Posted
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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
In this Louisiana Medicaid individual contributor role, the Manager, Contract Negotiations will:
• Recruit, negotiate and execute physical and behavioral health provider contracts to ensure attainment of Aetna Better Health of Louisiana network expansion and adequacy targets.
• Optimize interaction with assigned providers and internal business partners to facilitate relationships and ensure provider needs are met.
• Responsible for identifying and managing cost issues and initiating appropriate cost saving initiatives and/or settlement activities.
• Assists with the design, development, management, and implementation of strategic network configurations and integration activities.
• Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information.
• Manages complex, contractual relationships with providers according to prescribed guidelines in support of national and regional network strategies.
• Collaborates cross-functionally to manage Hospital, Ancillary and 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
Required Qualifications
• 3-5 years of related experience with successful track record negotiating managed care provider contracts with physician groups, hospitals, and/or ancillary services
• In-depth knowledge of the managed care industry and practices, as well as a strong understanding of strategies and financial/contracting reimbursement methodologies
• Strong communication, critical thinking, problem resolution and interpersonal skills
• MS Office Suite proficiency
• Ability to travel in assigned market up to 15% of the time as needed
• Resident of Louisiana- Hybrid (able to work in Baton Rouge office at least 1-2x/mo)
Preferred Qualifications
• Knowledge of Louisiana Medicaid provider and payor landscape
Education
• Bachelor’s degree or equivalent combination of education and 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.
About us
Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.