Description
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. *Position Summary* Reporting to the Executive Director of Vendor Networks & Nonpar Solutions, the Senior Manager of Rental Network Management is accountable for driving operational excellence, owning strategic vendor partnerships, and overseeing business critical rental network operations. The Senior Manager will be managing established rental network vendors, negotiating and executing Vendor contracts and amendments; conducting high level reviews and analysis relative to access, adequacy, utilization, access fee reporting, and/or settlement negotiations with rental network vendors and/or indirectly contracted providers, in accordance with company standards to maintain and enhance provider networks while meeting and exceeding access, quality, and financial targets. This role manages contract performance and operational activities to ensure positive relationships with network providers, including accurate and current provider databases, policies and procedures, and vendor oversight. Responsibilities include identifying and managing cost issues and collaborating cross functionally to execute cost saving initiatives. Collaborates with internal partners to assess effectiveness of tactical plan in managing costs. Ensures resolution of escalated issues related to claims payment, contract intent and parameters, or accuracy of provider contract and demographic information. * Engages/manages compliance and regulatory requirements with vendors and their downstream providers. * Facilitates highly cross-functional work (with PDS, MEU, Legal, PSS, Sales, Network, and others) to successfully develop and manage third-party vendor relationships. Responsibilities include, but are not limited to: * Researching potential vendor alternatives and conducting vendor partner selection process * Negotiating relationship parameters and contracts * Developing and executing on implementation plans * Ensuring operational/system readiness and integration * Managing and overseeing day-to-day operational activities * Manages and participates in day-to-day oversight of current vendors by: * Managing root cause analysis regarding a variety of issues that confront the rental vendors and their downstream providers including operational, member concerns, and other areas; tracking these issues and communicating effectively with stakeholders. * Leading monthly Status Calls and/or Joint Operating Committees with each vendor. * Reviewing monthly reporting from vendors and sharing with appropriate internal stakeholders * Managing and/or overseeing (including Delegation Oversight) vendors' activities * Ensures annual open enrollment readiness * Serves as subject matter expert and point person to direct, triage and support both provider complaints and member escalations. Will facilitate remediation with internal and external constituents * Creates solutions and develops the automation in Alteryx, Excel, and/or PowerBI * Analyzes data to determine root causes to results and create prudent initiatives to solve pain points * Provides forecasting/modeling support * Coordinates efforts from all constituents to create the optimal solution * Some travel may be required on a periodic basis * *Required Job Qualifications* * Knowledge of current health insurance marketplace and terminology * Proven working knowledge of provider financial and operational issues as they relate to health insurance * Consistently meets deadlines, works well under pressure, and keen organizational awareness. * Strong verbal, visual, and written communication skills to interact with all levels of corporate personnel, clients, and providers. * Proven project management of multiple complex projects simultaneously * Proactively works with business partners asking thoughtful thorough questions to understand the root cause of the issues * Strong communication, critical thinking, problem resolution and interpersonal skills * Ability to multi-task, prioritize and meet deadlines * Minimum of 5 years related experience and expert level negotiation skills with successful track record negotiating contracts with large or complex national providers. * Minimum of 5 years recent experience managing complex contractual relationships with providers including contract interpretation and knowledge of benefit plans * Ability to communicate and influence mid-level managers (Director and above), as demonstrated by 2+ years of experience creating and delivering leadership-facing materials and presentations * Strong Excel skills (pivot tables, V-lookup) * Experience with BI Launchpad, EPDB, Crystal, Alteryx, Access or Quickbase creation, Rumba, Strategic Contract Manager ,Tableau * Strong attention to detail and excellent analytical and problem-solving skills; ability to organize and analyze data * Excellent communication, negotiation, and presentation skills * Ability to collaborate cross-functionally across departments and various level roles in the organization * Able to manage time effectively, understand directions, and work independently in a fast-paced environment * Very strong willingness to learn and operate in ambiguity * Experience with provider contracts, contracting options, system loads as well as provider configurations. * Exceptional Customer Service Skills. * Data Analytics experience, transforming data into meaningful information * Project Management skills, managing multiple projects/initiatives at once and meeting project milestones *Preferred Qualifications * * Experience working with external vendors preferred * Resides in Midwest or East Coast time zones (or a willingness to abide by those time zones) * Team lead or people manager and project management experience * Experience contributing to high-profile CVS Health Enterprise initiatives (e.g. Enterprise Operating Model, acquisitions, etc.) * Experience collaborating and influencing internal and external partners to develop adjudication and data solutions, methodologies and reporting * Demonstrated ability to manage multiple projects simultaneously, prioritizing effectually, and meeting deadlines * Effectively able to engage and persuade stakeholders of all levels with a high degree of written and verbal communication skills * Proven ability to produce high-yield results for value-add programs * Operational understanding with the ability to analyze high volumes of data and produce actionable work streams with a focus on superior quality results *Education, Training, And Professional Experience* Bachelor's degree or additional equivalent experience required 8 – 10 years related health care experience in health operations, network management, network relations and development, command of financials and pricing strategies, and sales interface. *Pay Range* The typical pay range for this role is: $67,900.00 - $174,200.00 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. This position also includes an award target in the company's equity award program. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit [jobs.CVSHealth.com/benefits](https://jobs.cvshealth.com/benefits) We anticipate the application window for this opening will close on: 06/28/2024
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