Senior Manager – Strategic Planning-Provider Network Management
| Company | CVS Health |
|---|---|
| Location | Morrisville, NC, USA, Wheeling, IL, USA, Jackson Township, NJ, USA, Dallas, TX, USA, South Carolina, USA, Smithfield, RI, USA, Georgia, USA, Arizona, USA, Trenton, OH, USA, Tennessee, USA, Ambler, PA, USA, Hartford, CT, USA, Oklahoma City, OK, USA, Phoenix, AZ, USA, North Carolina, USA, Missouri, USA, Plantation, FL, USA |
| Salary | $67900 – $182549 |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Senior |
Requirements
- 5+ years of analytical experience in network, contracting, pricing, finance and/or market with proficiency utilizing Microsoft Excel to include pivot tables, VLOOKUP’s, and etc.
- Ability to navigate web-based tools to gather information and turn into action.
- 5+ years Healthcare industry experience
- Adept at execution and delivery (planning, delivering, and supporting) skills.
- Strong communication skills in a highly matrixed environment.
Responsibilities
- Supports network teams in provider negotiations and financial risk for Commercial, Medicare, Medicaid, and IFP businesses.
- Work directly with network, provides current and relevant data to support provider negotiations.
- Communicate network performance analysis to Market leaders, noting drivers impacting pModel and SAIs (Scoreable Action Initiatives) and potential actions to mitigate costs across multiple Lines of Business.
- Utilize various data sources to identify market drivers and potential opportunities to improve market performance, e.g., HCIC (Health Care Information Center), pModel, SAI Database, QAT, COIN.
- Evaluate contract deviations and contract outliers, drive for improvement in costs to better position Aetna in the marketplace.
- Review and interpret medical transparency data; summarize and communicate potential contracting opportunities to network.
- Leverage colleagues and business partners to identify and resolve issues as they arise.
- Collaborate across the organization to ensure complete projects.
Preferred Qualifications
- Bachelor’s degree preferred