Community Manager (CONTRACT)

We’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. This is an individual contributor role. The Senior Contract Manager for First Health Network Management serves as the subject matter expert in support of contracting initiatives and data audits to enhance provider networks while meeting and exceeding accessibility, compliance, quality, and financial goals. Responsible for reviewing, building and auditing complex contract and network data, support recruitment efforts, and collaborating on negotiations as needed. Role/Responsibilities Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with solo, small group, or local providers, including SCAs, LOAs, and PPAs. Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities. Responsible for identifying and managing cost issues and collaborating cross functionally to execute significant cost saving initiatives. Represents company with high visibility constituents, including customers and community groups. Promotes collaboration with internal partners. Manages contract performance in support of network quality, availability, and financial goals and strategies. Recruits providers to ensure attainment of network expansion

We’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. Position Summary : This is an individual contributor role. The Contract Manager serves as the subject matter expert in support of contracting initiatives and data audits to enhance provider networks while meeting and exceeding accessibility, compliance, quality, and financial goals. Responsible for reviewing, building and auditing complex contract and network data, support recruitment efforts, and collaborating on negotiations as needed. Role/Responsibilities Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with solo, small group, or local providers, including SCAs, LOAs, and PPAs. Manages contract performance in support of network quality, availability, and financial goals and strategies. Recruits providers to ensure attainment of network expansion and adequacy targets. Collaborates cross-functionally to contribute to provider compensation and pricing development activities and recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities. Responsible for identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities. Provides network development, maintenance, and refinement activities and strategies in sup

We’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. Position Summary This is an individual contributor role. Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with smaller providers ( (i.e. local, individual providers, small groups/systems), services larger provider partners in accordance with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, compliance, quality, and financial goals and cost initiatives. What you will do Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with solo, small group, or local providers. Manages contract performance in support of network quality, availability, and financial goals and strategies. Recruits providers as needed to ensure attainment of network expansion and adequacy targets. Collaborates cross-functionally to contribute to provider compensation and pricing development activities and recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities. Responsible for identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities. Provides network development, maintenance, and refinement activiti

We’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. As a Contract Negotiation Manager, you will play a critical role in shaping and strengthening our provider network. You will lead contract negotiations, manage provider relationships, and identify strategic opportunities to enhance access, quality, compliance, and cost efficiency. This role partners across the organization to deliver value-based contracting strategies that support business goals and improve overall network performance. What You’ll Do This is an individual contributor role. Manages contract performance, and drives the development and implementation contract relationships in support of business strategies. Recruits providers as needed to ensure attainment of network expansion and adequacy targets. Accountable for cost arrangements within defined groups. Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities. Responsible for identifying and managing cost issues and collaborating cross functionally to execute significant cost saving initiatives. Represents company with providers, groups and health systems. Promotes collaboration with internal partners. Evaluates, helps formulate, and implements the pro

We’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. Position Summary At Aetna®, part of CVS Health, we proudly serve more than 26 million medical members through our broad range of health plan offerings. We're committed to delivering a simpler, more meaningful, and personal health care experience to each of them. As a Senior Manager Medicare Product, Vendor Management Contract Lead you will play a critical role contracting, negotiations, oversight of vendors and assisting in achieving CVS goals, work strategically together, and remain as adaptable as possible in an ever-changing environment. This role's scope of responsibility includes overseeing the following in relation to Medicare Product vendor management: Finance, Contracts, Invoicing, Negotiations, Provisioning, Aetna Medicare Supplemental & Duals benefits, Vendor relationship management, Compliance oversight, Auditing, and projects as assigned. The Senior Manager, Vendor Management Contract Lead is a high impact role. You will lead advance contract and negotiation skills, work with other partner to identify root cause, address, and resolve vendor issues, manage vendors to the contract SLAs, performance guarantees and provide insight into complex vendor problems. Responsibilities include: Work assignments involving moderately complex to complex issues where the analysis of situations or data requires an in-dep

We’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. Role Summary Supports the development and execution of strategic advisory on Trade-related topics (pharmaceutical purchasing and contracting) for the PBM Client Underwriting organization. Contributes to strategies by analyzing market intelligence and data insights, partnering with cross-functional stakeholders, and delivering actionable recommendations. Develops appropriate responses and documentation to address Trade-related requests arising from state Market Conduct Examinations . Manages processes and ensures consistent delivery of insights to support business outcomes. What You Will Do Provide strategic advisory on Trade implications of PBM client pricing strategies and client requests, partnering with cross-functional stakeholders to address business needs Contribute formulary, rebate, and other Trade insights to inform Underwriting RFP strategy and enhance rebate value for prospects and renewing clients Ensure Trade-related contractual requirements are appropriately addressed within RFP responses Serve as Trade liaison to Compliance team and other pertinent stakeholders on growing work to support state Market Conduct Exam inquiries, leading Trade response efforts on requests and follow-ups Provide input on key Underwriting assumptions that may impact future rebate value Analyze and apply market intelligence