Manager Network Relations - Must live in NJ

Company: CVS Health
Location: Princeton
Posted on: June 26, 2022

Job Description:

Job DescriptionActs as the primary resource for assigned profile of larger and more complex providers (i.e. market/ regional/national, large group or hospitalsystems) to establish, oversee, and maintain provider risk management and positive relationships and supports high value initiative activities.Drives the implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets.May have limited contract negotiation responsibilities for assigned providers.
Optimizes interactions with assigned providers and internal business partners to establish and maintain productive, professional relationships and partners on the development of business strategy and programs tosupport the operational plans. Collaborates cross-functionally to ensure resolution of escalated issues or projects for assigned provider systemsand monitors performance and adherence to scorecards and payout schedules based on established quality, growth, and clinical measures.Educates internal and external parties as needed to ensure compliance with contract policies and parameters, plan design, compensation process,technology, performance measurement techniques, policies, and procedures. Meets with key providers periodically to ensure service levelsare meeting expectations. Manages the development of agenda, validates materials, and facilitates external provider meetings. May collaborate cross functionally on the implementation of large provider systems, to managecost drivers, data reports and execute specific cost initiatives to support business objectives and to identify trends and enlist assistance in problemresolution. May be responsible for provider recruitment, contracting, or recontracting activities, or may assist and support more complex contractingand discussions. May provide guidance and training to less experienced team members.Required Qualifications- 3 to 5 years of experience in provider relations.- Must live in NJ- Working knowledge of Medicaid start upsCOVID RequirementsCOVID-19 Vaccination RequirementCVS 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 QualificationsStrong verbal and written communication, interpersonal, problem resolution and critical thinking skills with proven ability to influence and collaborate with providers and partners at all levels.4+ years' experience in business segment specific environment servicing ormanaging non-standard relationships with providers with exposure to benefit plan design and/or contract interpretation.3-5 years' experience with business segment specific policy, benefits, plan design and language.Working knowledge of business segment specific codes, products, and terminology.- Knowledge of Microsoft Word and Excel.EducationBachelor's Degree or equivalent combination of education and experience.Business OverviewBring your heart to CVS HealthEvery 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.

Keywords: CVS Health, Trenton , Manager Network Relations - Must live in NJ, Executive , Princeton, New Jersey