Medicaid Network Contracts Analyst

CVS Health; Illinois; Hybrid; USD 48,000 - 112,000; 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 Contract Coordinator Analyst to support the Medicaid Network management team for Aetna Better Health of Illinois. You will help ensure accuracy of provider contract documentation and maintain provider information across internal systems throughout the contracting lifecycle.

Key duties include reviewing contracts, loading new providers, auditing records, maintaining the contract repository, handling inquiries, and supporting compliance with state and federal regulations.

Qualifications

• 2-5 years of professional work experience, 1 year in the healthcare industry
• Experience with TriZetto QNXT
• Experience with medical terminology
• Experience 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
• Load contracted providers to the provider record database in a timely manner
• Audit provider records and submit corrections as needed
• Maintain the master repository of participating provider contracts
• Manage contracting team email box and respond within established turnaround times
• Respond to inquiries from providers and internal staff regarding contractual matters
• Send out provider welcome packets to newly contracted providers
• Support internal contract auditing processes
• Compile, summarize and report on contract submission compliance monthly
• Assist with claims projects and reviewing contracts and plan documents
• Ensure compliance with regulatory standards
• Escalate issues to management
• Identify process improvements with Network Development

Skills

Healthcare terminology

Microsoft Office

Time management

Written & verbal communication

Education

GED

Bachelor's degree preferred

Tools

TriZetto QNXT

SQL

Microsoft Excel

Business reporting

Job description

CVS Health is seeking a Contract Coordinator Analyst to support the Medicaid Network management team for Aetna Better Health of Illinois. You will help ensure accuracy of provider contract documentation and maintain provider information across internal systems throughout the contracting lifecycle.

Key duties include reviewing contracts, loading new providers, auditing records, maintaining the contract repository, handling inquiries, and supporting compliance with state and federal regulations.