Manager, Business Consultant

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

The Manager, Business Consultant is front facing to the vendor partners conducting reviews and analysis of contractual obligations. High focus on partnering with our internal and external constituents, this role will ensure performance programs and workflows are delivered accurately and on time. Responsibilities will include monitoring reporting, evaluating workflows and/or processes to meet the state needs and achieve positive business results.

The Manager, Business Consultant will foster strong, ongoing client relationships by transferring knowledge, best practices (external and internal), methodology and tools to client organizations.

∙ Supports health plan with expansion initiatives or other contracting activities as needed.
∙ Supports contracting activities to fulfillment including receipt and processing of contracts and documentation and pre- and post-signature review of contracts and language modification according to Aetna’s established policies.

∙ Conducts research, analysis and/or audits to identify issues and propose solutions to protect data, contract integrity and performance.
∙ Manages contract performance and contract relationships in support of business strategies.
∙ 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.
∙ Provides Subject Matter Expert support for questions related to contracting, provider issues/resolutions, related systems and information contained.

Provides guidance and shares expertise to others on the team.
∙ Manages high level projects with interdepartmental resources and/or cross functional stakeholders.
∙ May participate in JOC meetings.
∙ Supports or assists with operational activities that may include, but are not limited to, database management and contract coordination.
∙ Using data to predict trends in the customer base and the consumer population as a whole
∙ Performing statistical analysis of data.
∙ Preparing reports and presenting these to leadership.
Required Qualifications

∙Knowledge of network contracting/management experience.
∙ Experience with negotiating and decision-making skills while executing national, regional, or market level strategies.

∙ Knowledge of Medicaid programs.

-Strong relationship building skills

-Ability to read, run and understand reporting

∙ Ability to travel nationally as needed (up to 25% travel)
∙ In-depth knowledge of the managed care industry and practices, as well as a strong understanding of strategies, practices, and financial/contracting arrangements.

Preferred Qualifications

∙ Minimum 5+ years of network contracting/management experience.
∙ Minimum 5+ years of solid negotiating and decision-making skills while executing national, regional, or market level strategies.
∙ Knowledge of Medicaid programs.

∙ Ability to travel nationally as needed (up to 25% travel)
∙ In-depth knowledge of the managed care industry and practices, as well as a strong understanding of strategies, practices, and financial/contracting arrangements.
Education
Bachelor's degree desired and/or equivalent work experience.

Pay Range

The typical pay range for this role is:

$60,300.00 - $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. 
 
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

We anticipate the application window for this opening will close on: 05/31/2024