Lead Director, Network Management (healthcare) – CVS Health

5% 1-Year Employee Growth Rate | 13% 2-Year Employee Growth Rate | LinkedIn | $0 Venture Funding

What Is Employee Growth Rate & Why Is It Important?

Job Description
The initial objective of this Lead Director role is to develop direct provider networks for commercial and Medicare product lines in Wyoming and Montana. This role can be remote.

In achieving this objective, this position is responsible to:

1) Develop partnerships with key strategic providers to ensure Aetna has market leading discount and cost positions as well as highly competitive network offerings.

2) Develop and execute contracting strategies to achieve these objectives and partner with Medical Economics to assess and improve effectiveness of strategic and tactical plans to manage medical costs.

3) Support Sales teams to win business and grow and maintain membership.

4) Ensure alignment with internal guidelines and financial standard and targets.

5) Mentor and develop other team members.

Required Qualifications
8+ years related experience in health operations, network relations and development, command of financials and pricing strategies, and sales interface.

COVID Requirements

COVID-19 Vaccination Requirement
CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

Preferred Qualifications
Experience with value-based contracting.

In-depth knowledge of various reimbursement structures and payment methodologies for both hospitals and providers

In-depth knowledge of managed care business.

Experience building and maintaining relationships with provider systems.

A successful track record managing and negotiating major provider contracts

Solid leadership skills.

Analytical skills along with advanced Excel and Access.

Actuarial experience is a plus.

Preferred locations: –Wyoming, Montana, or Utah location required (work from home in one of these states).

Education
Bachelor’s degree or equivalent work experience

MBA/master’s degree preferred

Business Overview
Bring your heart to CVS Health
Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand – with heart at its center – our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
We strive to promote and sustain a culture of diversity, inclusion and belonging every day.
CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Tagged as: 501+ Employees, Hide US-Only Jobs, Venture Funded