CVS Health Jobs in Texas

Contract NegotiatorWe'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.

At Aetna Better Health of Texas, we are committed to helping people on their path to better health. By taking a total and connected approach to health, we guide and support our members so they can get more out of life, every day.

We are looking for people like you who value excellence, integrity, caring and innovation. As an employee, you'll join a team dedicated to improving the lives of Texas members. We value diversity and are dedicated to helping you achieve your career goals.

In this Texas Medicaid individual contributor role, the Contract Negotiator will:

Negotiate competitive contracts with health care providers using pre-determined internal guidelines and financial standards.

Negotiate contract language in accordance with Aetna standards, engaging other departments as needed for review and approval of contract terms outside the standards.

Manage contract performance and work with various internal departments to address questions, issues, and activities related to execution, loading, and ongoing maintenance of provider contracts.

Manage relationships with key providers and ensure resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information.

Negotiate settlements as needed. May recruit providers as needed to ensure network adequacy and achievement of network expansion goals. Maintain accountability for specific medical cost initiatives.

Required Qualifications

5 to 7 years of experience negotiating contracts with ancillary providers, physician groups, and IPAs, including contract language, development, and analysis of rate proposals, identifying operational and financial improvement opportunities, and collection and analysis of data and key financial metrics.

5 to 7 years of working knowledge of contracting options, provider reimbursement methodologies and terms, and contract setup. Understanding of provider financial issues, industry standard payment policies, regulatory requirements, and competitor strategies.

• Must be proficient in Word, Excel, and Microsoft Office.

Preferred Qualifications

Medicaid contracting experience.

Proficiency in the QNXT application.

Able to successfully manage multiple negotiations, issues, and other tasks to ensure completion and meet deadlines.

Able to manage expectations and maintain strong relationships, both internally and externally.

Candidates should reside in Texas.

Education

Bachelor's Degree or equivalent combination of education and professional work experience.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$60,300.$0 - $132,600.00

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 our comprehensive and competitive mix of pay and benefits investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.

No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.

Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.