Scottsdale, Arizona

Job Description
**This position can be located anywhere and can work remotely**

What a great time to join CVS Health, a Fortune 5 Company! CVS Health has a new opening for Senior Advisor working with our Provider Network group managing the provider network and contracting functions.

The Senior Advisor, Centene/WellCare Network Development is primarily responsible for developing strategies for effective management of the provider network contract function.

Essential duties include:
• Directing the provider network and contracting activities for Centene/WellCare network services. Lead all aspects of provider network strategy including, access analysis, network operations and support.
• Establish the department’s strategic vision, objectives, and policies, and procedures for all Centene/WellCare related network activity.
• Serves as expert negotiator for large national and regional pharmacy chains/PSAOs and setting strategic goals for network offerings, negotiation terms and conditions to meet Centene/WellCare objectives.
• Troubleshoots and negotiates pharmacy network rates with key pharmacy chains/PSAOs for inclusion in national and client-specific networks to meet network access performance guarantees and manage to pharmacy and client COGS.
• Instrumental in garnering key chain/PSAO partners for narrow networks and niche network offerings; leverages market share and industry knowledge to drive deals to meet Centene/WellCare goals (by market segment, client-specific and government-related)
• Helps set pharmacy contract rates to improve Caremark COGs and increase revenue; pro-actively identifies and maintains strategic chain/PSAO pharmacy partnerships when warranted; leads development of new networks and client-specific networks to the retail pharmacy network; fulfills network initiatives designed to increase Centene/WellCare Savings and PBM revenue; develops reporting methodologies to use in making network decisions

Required Qualifications
-7 years network contract expertise including developing, negotiating and managing network contracts.
- 7 years progressive, strategic experience with a Managed Care, HMO, TPA, state/regulatory agency or equivalent PBM experience
- 7 years interacting with executive-level and chain management staff (VP Pharmacy, Director of Pharmacy, Director of Third Party, Director of Pharmacy Operations, Manager of Third Party)
- Demonstrated negotiation experience in developing key partnerships and management of team to executive strategic initiatives on time and under budget
- Expert negotiation and communication skills
- Knowledge of retail chain pharmacy operations and pharmacy software products
- Key knowledge of industry -- PBM, retail pharmacy and pharmaceutical manufacturer programs and initiatives
- Executive management and planning skills
-Understanding of state pharmacy laws, rules and regulations
- Strong presentation skills to both small and large strategic groups

Preferred Qualifications
Retail Pharmacy experience
Clinical experience

Bachelor Degree in Healthcare Administration, Business Administration

Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited 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. See Job Description

Scottsdale, Arizona

Continue serving and work with a purpose

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Careers for Veterans and Military Spouses


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