oversee, and maintain provider contracts in SCM and support provider contract related activities. Serves as local market SCM expert. Works with teams on initiatives impacting provider contracts, provider satisfaction, network growth, and efficiency. Local Market resource who creates, maintains, and loads provider contracts in SCM and submits requests in QB for MEU analysis in support of Network Managers. Maintains excellent working relationships internally; works collaboratively with CCU, PDS, Delegation, Claims, capitation, BIR, MEU, and NRMs. Internal facing only.
Understanding of claims and provider contracts, particularly complex hospital contracts and reimbursement methods.
3+ years' experience in business segment environment servicing providers with exposure to benefits and/or contract interpretation.
-Working knowledge of business segment specific codes, products, and terminology.
-3-5 years' experience with business segment specific policy and provider contracts.
-Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills.
-Experience using various systems and comfortable using complex applications for provider contract entry.
-Curious self starter who enjoys research.
-Optimizes interactions with internal business partners to establish and maintain productive, professional relationships.
-Collaborates cross functionally to ensure that the needs of constituents are met and that escalated issues related but not limited to, contract interpretation or parameters, and accuracy of provider contract or demographic information are resolved.
-Supports or assists with activities that may include, but are not limited to, database management, and contract coordination.
-May collaborate cross-functionally on the implementation of contracts or provider demographic updates.
Bachelor's degree or equivalent work experience
The typical pay range for this role is:
$46,900.00 - $117,400.00
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.
For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits