Analyst - Medicaid Network Operations

CVSHealth; Illinois; On-site; USD 47,000 - 112,000; Full time

Benefits offered by this job

Medical Coverage

Dental Coverage

Vision Coverage

Paid Time Off

Retirement Plan

Job summary

CVS Health is seeking a Contract Coordinator Analyst to support the Medicaid Network management team in Illinois. You will ensure provider contract documentation is accurate, load new providers into the system, and maintain contract records throughout the contracting lifecycle.

The role requires healthcare industry experience, TriZetto QNXT proficiency, and strong attention to detail. You will collaborate with cross-functional teams, manage inquiries, and help drive compliance with regulations

Qualifications

• 2-5 years of professional work experience, 1 year in the healthcare industry.
• Experience working in TriZetto QNXT.
• Experience with medical terminology.
• Experience working with Microsoft Office Suite.
• Proven ability to manage multiple workflows, prioritize effectively, and meet deadlines.
• Strong written and verbal communication skills.

Responsibilities

• Review incoming contractual documents for completeness and accuracy and coordinate with staff to obtain missing items.
• Load newly contracted providers into the provider record database.
• Audit provider records to ensure accuracy and submit corrections.
• Maintain the master repository of participating provider contracts and load new agreements.
• Manage the contracting team email box and respond to messages within established turnaround times.
• Address inquiries from providers and internal staff regarding contractual matters.
• Send welcome packets to newly contracted providers.
• Support internal contract auditing processes as requested.
• Summarize and report on the Health Plan’s compliance with contract submission rules monthly.
• Assist with claims projects/audits and reviewing contracts and plan documents.
• Ensure compliance with health plan, corporate, state, and federal regulations.
• Escalate issues to management promptly.
• Identify process improvements with Network Development and other departments.
• Perform other duties as assigned.

Skills

Healthcare industry experience

TriZetto QNXT

Medical terminology

Microsoft Office Suite

Time management

Written and verbal communication

Education

GED or equivalent

Bachelor’s degree preferred

Tools

SQL

Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

The Contract Coordinator Analyst plays a critical role in supporting the Medicaid Network management team throughout the provider contracting lifecycle for Aetna Better Health of Illinois. This position works hand in hand with the Network Contracting Manager to ensure the accuracy and integrity of provider contract documentation for new providers joining the network, maintaining up-to-date provider information within internal systems, and supports compliance with regulatory and organizational requirements. See breakdown of specific job responsibilities below:

• Perform thorough reviews of all incoming contractual documents to ensure completeness and accuracy; work with contracting staff to obtain missing or incomplete documents as needed
• Work with national provider data service team to load newly contracted providers to the provider record database in a timely manner
• Audit updated provider records to ensure the correct changes were made to the database; submit corrections as needed
• Maintain the master repository of participating provider contracts, load newly executed provider agreements to the repository
• Manage contracting team email box; appropriately respond and triage of both internal and external messages to the appropriate parties. Respond to emails within established turnaround times
• Research and respond to inquiries from providers and internal staff regarding contractual matters such as a provider’s participating status in the Aetna Better Health of Illinois provider network
• Send out provider welcome packets to newly contracted providers
• Support internal contract auditing processes as requested
• Compile, summarize and report on the Health Plan’s compliance with contract submission rules and exception requests, communicating on at minimum, a monthly basis
• Assist with miscellaneous claims projects/audits and reviewing contracts and plan documents
• Ensures compliance of health plan, corporate, state, and federal regulations
• Escalate issues, as necessary, to management in a timely manner
• Work with members of Network Development and internal department staff to identify process improvement opportunities
• Perform other duties as assigned

Required Qualifications

• 2-5 years of professional work experience, 1 year in the healthcare industry
• Experience working in TriZetto QNXT
• Experience with medical terminology
• Experience working with Microsoft Office Suite
• Proven ability to manage multiple workflows, prioritize effectively, and meet deadlines
• Strong written and verbal communication skills, with the ability to convey complex information clearly

Preferred Qualifications

• SQL Database Queries
• Intermediate Microsoft Excel skills (Excel formulas and pivot tables)
• Business reporting

Education

GED required, Bachelors preferred

Anticipated Weekly Hours 40

Time Type Full time

Pay Range

The typical pay range for this role is:

$46,988.00 - $112,200.00

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We 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: 08/27/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.