Position SummaryThe Senior Manager of Network Management is a critical role in advancing the organization's Value-Based Contracting (VBC) strategy for the Louisiana Medicaid Market. This position is essential to developing and managing provider relationships that drive improved health outcomes, cost efficiency, and compliance with state and federal Medicaid obligations.
- Directs groups to manage provider contract performance and supports the development and implementation of strategic, value-based contract relationships.
- Applies highly developed knowledge to negotiate Network contracts with healthcare providers, establish reimbursement rates, service agreements, and performance metrics.
- Advises on provider performance, network adequacy, geographical coverage, and member satisfaction, and makes necessary network modifications or expansions.
- Implement improvement initiatives to ensure that network providers meet all applicable regulatory and quality standards.
- Develops and expands the network, identifying and contracting with healthcare providers, including hospitals, physicians, specialists, and ancillary service providers.
- Conducts market analysis, assesses competitive positioning, and recommends strategies to maintain a competitive edge.
- Interfaces with the finance team on budgeting, cost analysis, and financial forecasting, to manage the financial aspects of provider network management.
- Consults with internal teams, including medical directors, operations managers, and network development professionals, to align provider network performance goals and objectives.
- Provides continuous recommendations to senior leadership to guide decision-making and ensure close alignment with the organization's strategic goals and objectives.
Required Qualifications- Minimum 7 years of experience in provider network management, contract negotiations, or value-based contracting within Medicaid or managed care programs.
- Strong understanding of Medicaid reimbursement models, value-based care, and risk sharing arrangements.
- Demonstrated ability to analyze financial and quality performance data and implement process improvements.
- Experience with provider performance measurement, quality improvement and building strong provider partnerships.
- Reside in the Louisiana market.
Preferred Qualifications- Adept at problem solving and decision-making skills
- Adept at collaboration and teamwork
- Adept at growth mindset (agility and developing yourself and others) skills
- Adept at execution and delivery (planning, delivering, and supporting) skills
- Adept at business intelligence
Education- Bachelor's degree preferred/specialized training/relevant professional qualification.
Pay RangeThe typical pay range for this role is:
$67,900.00 - $149,328.00
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.
Great benefits for great peopleWe take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.
Additional details about available benefits are provided during the application process and on Benefits Moments.
We anticipate the application window for this opening will close on: 08/29/2026
