CVS Health · 8 hours ago
Senior Manager, Medicaid Network Management (Maryland)
United States
Full-time
Remote
Mid, Senior Level
$83K/yr - $183K/yr
7+ years expCVS Health is a leading health solutions company committed to transforming health care. The Senior Manager, Medicaid Network Management will negotiate and manage contracts with complex provider systems to enhance provider networks while ensuring compliance with healthcare regulations.
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Responsibilities
Analyzes market needs and opportunities for network expansion, identifies gaps in the existing network, and proactively seeks new provider relationships to address those gaps
Ensures governance with healthcare regulations and contractual requirements, implementing strategies and processes to adhere to guidelines and requirements
Initiates moderate and/or complex contracting activities, including the collection of all required contract and credentialing documents, and obtains the necessary approval of non-standard rates and language modifications to contracts
Collaborates on negotiations or may handle contracting and re-contracting discussions with providers, provider groups and/or health systems
May participate in various internal and/or external meetings, serving as representative on behalf of the department
Supports or assists with operational activities that may include, but are not limited to, database management and contract coordination
Provides ongoing recommendations to leadership to guide decision-making and ensure alignment with the organization’s strategic goals
Coaches and mentors more junior level colleagues in contracting techniques, processes and responsibilities
Qualification
Required
7+ years related experience and expert level negotiation skills with successful track record negotiating contracts with large or complex provider systems
Strong communication, critical thinking, problem resolution and interpersonal skills
Proven working knowledge of provider financial issues and competitor strategies, complex contracting options, financial/contracting arrangements and regulatory requirements
Medicaid Network Management experience, preferably Maryland Medicaid program
Preferred
Bachelor's Degree Preferred Or Relevant Professional Experience
Residing within the state of Maryland highly preferred, will consider other locations within the DMV area
Benefits
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.
Company
CVS Health
CVS Health is a health solutions company that provides an integrated healthcare services to its members.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$4BKey Investors
Michigan Economic Development CorporationStarboard Value
2025-08-15Post Ipo Debt· $4B
2025-07-17Grant· $1.5M
2019-11-25Post Ipo Equity
Leadership Team
David Joyner
President and Chief Executive Officer, CVS Health
Chandra McMahon
SVP & CISO
Recent News
2026-01-25
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