Network Relations Manager (Metro New York Market)

CVS Health Provider Risk Management

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary :

Acts as the primary resource for assigned profile of larger and more complex providers (i.e. market / regional / national, large group or hospital systems) 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 to support the operational plans. Collaborates cross-functionally to ensure resolution of escalated issues or projects for assigned provider systems and 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 levels are 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 manage cost drivers, data reports and execute specific cost initiatives to support business objectives and to identify trends and enlist assistance in problem resolution. May be responsible for provider recruitment, contracting, or re-contracting activities, or may assist and support more complex contracting and discussions. May provide guidance and training to less experienced team members.

Required Qualifications :

Strong 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 or managing non-standard relationships with providers with exposure to benefit plan design and / or contract interpretation. Working knowledge of business segment specific codes, products, and terminology. Ability to travel up to 25% of the time in assigned territory

Preferred Qualifications :

Knowledge of Metro NY Network market Knowledge Microsoft Suite with intermediate Excel experience Education Bachelor's Degree or equivalent combination of education and experience.

Anticipated Weekly Hours 40

Time Type Full time

Pay Range The typical pay range for this role is : $66,330.00 - $145,860.00

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.

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.

We anticipate the application window for this opening will close on : 10 / 22 / 2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.