Negotiation Manager - PA, DE, NY, NJ, MD, or Washington, DC

Position Summary

• Negotiate, execute, and conduct high-level review and analysis of dispute resolution and settlement negotiations of contracts with large, complex, and national group/system providers to maintain and enhance provider networks while meeting accessibility, quality, and financial goals.
• Recruit providers as needed to achieve network expansion goals and regulatory or internal adequacy targets.
• Support health plan expansion initiatives and other contracting activities as required.
• Initiate, coordinate, and own contracting activities through fulfillment, including receipt and processing of contracts, pre- and post-signature review, and language modification per company policies.
• Audit, build, and load contracts, agreements, amendments, and fee schedules into contract management systems per established policies.
• Collaborate cross-functionally to manage provider compensation, pricing development, and submission of contractual information, as well as to review and analyze reports for negotiation and reimbursement modeling.
• Provide subject‑matter expertise on recruitment initiatives, contracting, provider issues/resolutions, and related systems.
• Apply understanding of value‑based contracting and negotiations.
• Prepare reports and present findings to Network Management leadership.
• Engage with providers and expedite contracting processes to meet network adequacy standards.

• 5+ years of experience in healthcare network contracting and provider relationship management.
• 3–5 years of solid negotiating and complex decision‑making skills while executing national, regional, or market level strategies.
• Demonstrated knowledge of the managed care industry, including reimbursement models, regulatory requirements, and contracting best practices.
• Working knowledge of behavioral health topics related to managed care plans.
• Advanced proficiency in Microsoft Office Suite, particularly Excel for data analysis, modeling, and reporting, and PowerPoint for executive presentations.
• Proven ability to build and maintain collaborative provider relationships and partner cross‑functionally to resolve complex contract or network issues, with examples of successful issue resolution or stakeholder alignment.
• Bachelor’s degree or equivalent professional work experience.
• Residency requirement: candidates must reside in PA, DE, NY, NJ, MD, or Washington, DC.

• Health plan experience supporting behavioral health provider networks.
• General knowledge of reporting tools for contract financial analysis and modeling.
• Demonstrated decision‑making skills while executing national, regional, and market level strategies.
• Strong critical thinking, issue resolution, interpersonal, and problem‑solving abilities.
• Excellent interpersonal and communication skills, including the ability to convey complex information clearly both verbally and in writing to diverse stakeholders.

The typical pay range for this role is $66,330.00 – $; the actual base salary offer will vary based on 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.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of employees and their families. Benefits include medical, dental, and vision coverage; paid time off; retirement savings options; wellness programs; and additional resources.

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