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Lead Director, Network Management (Kentucky) at CVS Health - ApplyBlast

Lead Director, Network Management (Kentucky)

CVS Health

4 months ago

3.2 on Glassdoor

Onsite

Full Time

Senior

0 applicants

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About this role

The Kentucky Network Lead Director at CVS Health (Aetna) develops strategic partnerships and manages complex contracts with hospital systems and provider groups for the Kentucky Medicaid Health Plan. This role involves designing conceptual models, negotiating high-value agreements, and ensuring network adequacy while driving cost-saving initiatives and value-based payment models. The position requires cross-functional collaboration to enhance provider engagement and maintain compliance with state regulations.

Responsibilities

Develop strategic partnerships for Kentucky Medicaid Health Plan
Negotiate high-value contracts with complex hospital systems
Design conceptual models and initiative planning
Execute cost-saving initiatives and manage provider compensation
Ensure compliance with Medicaid regulations and network adequacy

Skills

Qualifications

Bachelor's DegreeMedicaid Regulations Knowledge10+ Years ExperienceExpert Negotiation SkillsProvider Network Management Experience

About CVS Health

cvshealth.com

Headquarters

Woonsocket, Rhode Island, United States

Company Size

10001+ employees

Founded

1963

View Profile

CVS Health is America's leading health solutions company, providing integrated services across retail pharmacy (CVS Pharmacy), pharmacy benefits management (CVS Caremark), and health insurance (Aetna). The company offers pharmacy services, health plans, clinical care (including MinuteClinic), and health-and-wellness programs for consumers, employers, and government payers. By combining a large national retail footprint with claims processing, care management, and clinical services, CVS Health aims to coordinate care, lower costs, and improve health outcomes. Businesses and consumers use its solutions for medication management, plan administration, and in-person and virtual care.