Medicaid Network & Contract Data Specialist

CVS Health; Wyoming (OH); Hybrid; USD 47,000 - 122,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Network Configuration Specialist to optimize provider networks through rigorous contract management and data audits, ensuring accessibility, compliance, quality, and financial performance. The role supports recruitment, negotiates terms, and trains junior staff in best practices.

The ideal candidate will have 3–5 years of Medicaid/claims experience, strong Excel/SQL skills, and the ability to work standard CST business hours.

Qualifications

• Experience with Medicaid and claims processes.
• Proficient with internal systems including Excel and SQL.
• Bachelor’s degree or specialized training/certification requested.

Responsibilities

• Assist with establishing and implementing results-based programs for network operations.
• Provide feedback for decisions and strategies to enhance growth and visibility.
• Design, load, and audit complex contracts and fee schedules in management systems.
• Conduct research and audits to protect data integrity and performance.
• Coordinate contracting activities and post-signature review of contracts.
• Coach junior colleagues on processes and responsibilities.
• Perform other duties as needed.

Skills

Medicaid and claims

Excel

SQL

Multi-disciplinary team

Critical thinking

Customer service

Self-motivation

Education

Bachelor’s degree or specialized training/certification

High school diploma or GED

Tools

Microsoft Excel

SQL

Job description

CVS Health is seeking a Network Configuration Specialist to optimize provider networks through rigorous contract management and data audits, ensuring accessibility, compliance, quality, and financial performance. The role supports recruitment, negotiates terms, and trains junior staff in best practices.

The ideal candidate will have 3–5 years of Medicaid/claims experience, strong Excel/SQL skills, and the ability to work standard CST business hours.