Manager, Contract Negotiations (Louisiana Medicaid)

Start free →

Or apply yourself on the official page →

About the role

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 40 Time Type Full time Pay Range The typical pay range for this role is: $54,300.00 - $119,340.00 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. 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. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings op

View the official posting →