What are the responsibilities and job description for the National Market Head of Network (Executive Director) position at CVS Health?
Job Description
The National Head of National Health Systems (Market Head of Network) will be accountable for leading and implementing the specific National Network strategy focused on optimizing national and local market network performance (Commercial and Medicare) and cost, delivering on strategic national network goals, ensuring national provider negotiations are successfully closed, and managing day-to-day operational components for his/her assigned national providers.
• Leads a national contracting team that leads corporate negotiations with large hospital/health systems, ambulatory surgery centers and national hospital-based physician groups (Direct accountability for national health system that represent billions of medical claims on an annual basis that include national hospital-based physician groups).
• Implements new national contracting strategies which support enterprise initiatives that leverage CVS integrated assets.
• Responsible for network and operational infrastructure aligned to cost related levers and ensuring the national network meet cost metrics, adequacy standards, network compliance regulations, and profitability goals.
• Serve as the national Corporate Witness for Civil Investigative Demand (DOJ), merger inquires with FTC, DOI investigations, provider mediations and other corporate settlement activities.
• Responsible for setting national network strategy and pushing innovation across traditional and non-traditional models for all lines of business, coordinating expansion activities, and driving towards local market and national goals with the large national health systems.
• Continually evaluate market and manage medical costs in close partnership with Clinical Functions and drives national change and oversight of key initiatives to improve cost structure partnership.
• Manages national agreements, national JOC’s, complex projects, simplifies and centralizes processes, works collaboratively and cross functionally amongst various business partners and local networks to enhance internal and external partnerships.
• Develop and maintain strong relationships with the Market Chief Network Officers and Territory Chief Network Officers; ability to converse with the respective Market Presidents, Market CFOs, and Medicare GMs to ensure alignment in developing and effecting strategies that drive profitable membership growth. This role will require significant executive presence and positive relationship and presentation skills and will be expected to facilitate senior executive discussion to secure applicable alignment.
• Responsible for developing the key messages and talking points to the external community and represent the company at key meetings, conferences and negotiations.
Pay Range
The typical pay range for this role is:
Minimum: 131,500
Maximum: 297,250
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Required Qualifications
• 10 years of healthcare experience including contracting, medical economics and field or national network experience.
• Experience contracting with providers and hospital systems including complex negotiations.
• Strong presentation and communication skills; ability to consult as well as negotiate.
• Strong analytical skills including root cause analysis
• Ability to think strategically and broadly from a national enterprise perspective.
• Skilled at collaborating and working across a complex matrixed organization.
• Management experience managing large, dispersed, highly skilled professional teams.
• Expertise in market level management, cost drivers and levers, and knowledge of economic, regulatory and marketplace issues.
Preferred Qualifications
• Preferred to have prior Local Market Network leadership managing Commercial and Medicare segments.
• Demonstrated successful hospital / health system negotiations and prior management of day-to-day operational components.
• The role reports to the National Partner Strategy National Lead.
Education
• Bachelor's Degree
Business Overview
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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
The National Head of National Health Systems (Market Head of Network) will be accountable for leading and implementing the specific National Network strategy focused on optimizing national and local market network performance (Commercial and Medicare) and cost, delivering on strategic national network goals, ensuring national provider negotiations are successfully closed, and managing day-to-day operational components for his/her assigned national providers.
• Leads a national contracting team that leads corporate negotiations with large hospital/health systems, ambulatory surgery centers and national hospital-based physician groups (Direct accountability for national health system that represent billions of medical claims on an annual basis that include national hospital-based physician groups).
• Implements new national contracting strategies which support enterprise initiatives that leverage CVS integrated assets.
• Responsible for network and operational infrastructure aligned to cost related levers and ensuring the national network meet cost metrics, adequacy standards, network compliance regulations, and profitability goals.
• Serve as the national Corporate Witness for Civil Investigative Demand (DOJ), merger inquires with FTC, DOI investigations, provider mediations and other corporate settlement activities.
• Responsible for setting national network strategy and pushing innovation across traditional and non-traditional models for all lines of business, coordinating expansion activities, and driving towards local market and national goals with the large national health systems.
• Continually evaluate market and manage medical costs in close partnership with Clinical Functions and drives national change and oversight of key initiatives to improve cost structure partnership.
• Manages national agreements, national JOC’s, complex projects, simplifies and centralizes processes, works collaboratively and cross functionally amongst various business partners and local networks to enhance internal and external partnerships.
• Develop and maintain strong relationships with the Market Chief Network Officers and Territory Chief Network Officers; ability to converse with the respective Market Presidents, Market CFOs, and Medicare GMs to ensure alignment in developing and effecting strategies that drive profitable membership growth. This role will require significant executive presence and positive relationship and presentation skills and will be expected to facilitate senior executive discussion to secure applicable alignment.
• Responsible for developing the key messages and talking points to the external community and represent the company at key meetings, conferences and negotiations.
Pay Range
The typical pay range for this role is:
Minimum: 131,500
Maximum: 297,250
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Required Qualifications
• 10 years of healthcare experience including contracting, medical economics and field or national network experience.
• Experience contracting with providers and hospital systems including complex negotiations.
• Strong presentation and communication skills; ability to consult as well as negotiate.
• Strong analytical skills including root cause analysis
• Ability to think strategically and broadly from a national enterprise perspective.
• Skilled at collaborating and working across a complex matrixed organization.
• Management experience managing large, dispersed, highly skilled professional teams.
• Expertise in market level management, cost drivers and levers, and knowledge of economic, regulatory and marketplace issues.
Preferred Qualifications
• Preferred to have prior Local Market Network leadership managing Commercial and Medicare segments.
• Demonstrated successful hospital / health system negotiations and prior management of day-to-day operational components.
• The role reports to the National Partner Strategy National Lead.
Education
• Bachelor's Degree
Business Overview
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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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