Contract Negotiation Manager

4062 Aetna Resources, LLC; Oregon; Hybrid; USD 60,000 - 133,000; Full time

Job summary

CVS Health is seeking an experienced Contract Manager to support contracting initiatives and data audits for a robust provider network. You will review, build, and audit complex contracts while collaborating on negotiations with healthcare providers to meet accessibility, quality, and financial goals.

You will manage contract performance, recruit providers, and work cross-functionally on compensation, pricing, and reimbursement modeling.

Qualifications

• 5+ years of working knowledge of the healthcare industry, including competitor strategies, complex contracting options, financial and contracting arrangements, and regulatory requirements.
• 3+ years of experience in provider relationship management or related healthcare roles, with proven and proficient contract management skills.
• Strong communication, critical thinking, problem-resolution and interpersonal skills.
• Proficiency in Microsoft Office Suite (e.g., Excel, Word, PowerPoint, Outlook).

Responsibilities

• Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with solo, small group, or local providers, including SCAs, LOAs, and PPAs.
• Manages contract performance in support of network quality, availability, and financial goals and strategies.
• Recruits providers to ensure attainment of network expansion and adequacy targets.
• Collaborates cross-functionally to contribute to provider compensation and pricing development activities and recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities.
• Responsible for identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities.
• Provides network development, maintenance, and refinement activities and strategies in support of cross-market network management unit.
• Assists with the design, development, management, and/or implementation of strategic network configurations, including integration activities.
• May optimize interaction with assigned providers and internal business partners to manage relationships and ensure provider needs are met.
• Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information.
• Interprets contractual requirements including federal and state regulations and NCQA.

Skills

Healthcare industry knowledge

Provider relationship management

Communication

Problem solving

Education

Bachelor's degree preferred

Tools

Microsoft Office

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:

This is an individual contributor role. The Contract Manager serves as the subject matter expert in support of contracting initiatives and data audits to enhance provider networks while meeting and exceeding accessibility, compliance, quality, and financial goals. Responsible for reviewing, building and auditing complex contract and network data, support recruitment efforts, and collaborating on negotiations as needed.

Role/Responsibilities

• Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with solo, small group, or local providers, including SCAs, LOAs, and PPAs.
• Manages contract performance in support of network quality, availability, and financial goals and strategies.
• Recruits providers to ensure attainment of network expansion and adequacy targets.
• Collaborates cross-functionally to contribute to provider compensation and pricing development activities and recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities.
• Responsible for identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities.
• Provides network development, maintenance, and refinement activities and strategies in support of cross-market network management unit.
• Assists with the design, development, management, and/or implementation of strategic network configurations, including integration activities.
• May optimize interaction with assigned providers and internal business partners to manage relationships and ensure provider needs are met.
• Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information.
• Interprets contractual requirements including federal and state regulations and NCQA.

Required Qualifications

• 5+ years of working knowledge of the healthcare industry, including competitor strategies, complex contracting options, financial and contracting arrangements, and regulatory requirements.
• 3+ years of experience in provider relationship management or related healthcare roles, with proven and proficient contract management skills.
• Strong communication, critical thinking, problem-resolution and interpersonal skills.
• Proficiency in Microsoft Office Suite (e.g., Excel, Word, PowerPoint, Outlook).

Preferred Qualifications

• Candidates residing on the West Coast are strongly preferred.
• Education Bachelor's degree preferred or a combination of professional work experience and education.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $60,300.00 - $132,600.00. 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.

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: 11/23/2026. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.