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　　Position Summary

　　The Lead Director, Network Management (Texas) is accountable for designing conceptual models, initiative planning, and negotiating Medicaid value based agreements with Texas providers, including health systems, clinically integrated networks, IPAs, FQHCs and others, in accordance with company standards in order to maintain and enhance Medicaid provider networks, while working cross functionally to ensure consistency with all contracting strategies and meeting and exceeding accessibility, quality, compliance, regulatory, and financial goals and cost initiatives.

　　Responsibilities include, but not limited to:

　　· Manages Medicaid contract performance and drives the development and implementation of value-based contract relationships in support of business strategies.

　　· 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.

　　· May optimize interaction with assigned vendors/providers and internal business partners to facilitate relationships and ensure provider needs are met.

　　· Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information.

　　· Strong communication, critical thinking, problem resolution, interpersonal skills, organizational and time management skills.

　　· Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization.

　　· Demonstrated ability to influence and collaboration with internal and external partners via strong written and verbal communications

　　Required Qualifications

　　· Minimum 7+ years related experience and expert level negotiation skills with successful track record negotiating contracts with large or complex national vendors/providers.

　　· Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements.

　　· Demonstrated ability to identify and manage initiatives that improve total medical cost and quality.

　　· Health Plan/Payer or Provider Systems experience

　　· Experience with value-based contracts.

　　Preferred Qualifications

　　· Medicaid regulatory experience

　　· Medicaid contracting & setup experience.

　　· Experienced in provider/vendor contract set up in core Aetna Medicaid systems (QNXT experience).

　　· Experience with providers in Texas and resident in Texas

　　Education

　　Bachelor's degree or equivalent professional work experience.

　　Pay Range

　　The typical pay range for this role is:

　　$100,000.00 - $231,500.00

　　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

　　CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

　　You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

　　CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [email protected] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.