Contracts and Pricing - Project Manager

Hispanic Alliance for Career Enhancement; Topeka (KS); On-site; USD 54,000 - 146,000; Full time

Job summary

An established industry player is seeking a detail-oriented Project Manager to join their Network Platform Solutions team. In this role, you will leverage your project management expertise to support IT projects focused on Strategic Pricer functionality. You’ll collaborate with cross-functional teams, analyze healthcare claims, and ensure effective implementation of project objectives. This position offers a dynamic work environment where your contributions will directly impact healthcare solutions for millions. If you are passionate about healthcare and thrive in a fast-paced setting, this opportunity is perfect for you!

Benefits

Affordable medical plan options

401(k) plan with matching contributions

Employee stock purchase plan

Wellness screenings

Tobacco cessation programs

Weight management programs

Confidential counseling

Financial coaching

Tuition assistance

Flexible work schedules

Qualifications

• 2-3 years of project management experience required.
• 5-7 years of healthcare insurance experience required.

Responsibilities

• Serve as a subject matter expert for Strategic Pricer.
• Monitor project progress and report on key metrics.

Skills

Problem-solving skills

Decision-making skills

Analytical skills

Communication skills

Collaboration skills

Adaptability

Education

Bachelor's Degree or equivalent experience

Tools

Microsoft Excel

Microsoft Word

Microsoft Teams

QuickBase

SharePoint

Job description

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary
We are excited to invite a highly motivated and detail-oriented Project Manager to join our team. The Project Manager will be part of the Network Platform Solutions - Contracts & Pricing Team to support Strategic Pricer IT projects. In this role, you will research and analyze Strategic Pricer functionality and enhancements for participating providers. This position offers a valuable opportunity for personal and professional growth, as you will play a key role in successfully delivering and executing enhancements while collaborating with various business partners.

Responsibilities include:

• Serve as a subject matter expert for Strategic Pricer
• Evaluates combinations of rate drivers and payment methods in the Rate Wizard applying Strategic Pricer concepts, to predict outcomes
• Contribute to maintenance of team training materials, including formulation of contract and/or claim examples, system mock-ups, and depiction of pricing outcomes
• Support other business initiatives and system projects as required
• Collaborate with cross-functional teams to ensure effective implementation of project objectives
• Monitor project progress and report on key metrics
• Facilitate meetings and discussions to gather feedback and drive project improvements
• Research and analyze claim inquiries regarding accuracy of Strategic Pricer and/or identify contract input errors
• Contracted Service Grouping Maintenance & coordination

Required Qualifications

• Strong problem-solving and decision-making skills.
• 2 to 3 years project management experience
• 5 to 7 years healthcare insurance experience
• Strong analytical skills and attention to detail.
• Excellent communication and collaboration skills.
• Ability to adapt to changing priorities and work effectively under pressure.
• Demonstrated ability to learn new concepts
• Demonstrated ability to successfully deliver assigned projects

Preferred Qualifications

• Demonstrated proficiency with Strategic Pricer logic and concepts
• Proficiency with SCM Rate Wizard input including non-preferred contracting options
• 2 to 3 years claims processing experience
• Working knowledge of EPDB
• Intermediate SCSR knowledge
• Proficiency in Microsoft: Excel, Word, and Teams
• ACAS claims participating provider knowledge a plus
• Familiarity with the various CMS payment methodologies supported by Strategic Pricer via Burgess software
• QuickBase and SharePoint user experience

Education
Bachelor's Degree or equivalent experience

Anticipated Weekly Hours
40

Time Type
Full time

Pay Range

The typical pay range for this role is:

$54,300.00 - $145,860.00

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 our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 05/30/2025

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