Medicaid Network & Contract Configuration Specialist

CVS Health; Tennessee; Hybrid; USD 47,000 - 122,000; Full time

Job summary

CVS Health is seeking a Network Configuration Specialist to apply contracting, data auditing, and network design to strengthen provider networks while meeting accessibility, quality, and financial goals. You will review contracts, support negotiations, guide junior colleagues, and collaborate with cross-functional teams.

A Bachelor’s or equivalent, and Medicaid/claims experience are preferred; 40-hour weeks in CST hours.

Qualifications

• 3–5 years of experience working with Medicaid and claims.
• Proficient in Microsoft Excel and SQL.
• Ability to work standard business hours CST Monday–Friday.

Responsibilities

• Assist with establishing and implementing results-based programs for the network operations area under supervision.
• Apply in-depth knowledge of network operations to provide feedback for decisions and strategies.
• Design, loading, and auditing of complex contracts and fee schedules in contract systems.

Skills

Medicaid experience

Claims data

Excel

SQL

CST hours

Education

High school diploma or GED

Bachelor's degree (preferred)

Job description

CVS Health is seeking a Network Configuration Specialist to apply contracting, data auditing, and network design to strengthen provider networks while meeting accessibility, quality, and financial goals. You will review contracts, support negotiations, guide junior colleagues, and collaborate with cross-functional teams.

A Bachelor’s or equivalent, and Medicaid/claims experience are preferred; 40-hour weeks in CST hours.