Medicaid Network Contracts Analyst — Impact & Compliance

CVSHealth; Illinois; On-site; USD 47,000 - 112,000; Full time

Benefits offered by this job

Benefits package

Job summary

CVS Health is seeking a Contract Coordinator Analyst to support the Medicaid Network management team in Illinois. You will help ensure contract documentation accuracy, load provider records, and maintain up-to-date information across internal systems.

The role involves reviewing contracts, responding to inquiries, aiding with audits, and ensuring compliance with regulations. A background in healthcare, familiarity with TriZetto QNXT, and strong MS Office skills are essential.

Qualifications

• 2–5 years of professional work experience, 1 year in healthcare.
• Experience working in TriZetto QNXT.
• Experience with medical terminology.
• Experience working 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 newly contracted providers to the provider record database.
• Audit provider records and submit corrections as needed.
• Maintain the master repository of participating provider contracts.
• Respond to emails and triage messages within turnaround times.
• Research inquiries regarding contractual matters and provider status.
• Prepare provider welcome packets for newly contracted providers.
• Support internal contract auditing processes.
• Summarize and report on contract submission compliance monthly.
• Assist with claims projects and review contracts and plan documents.
• Ensure compliance with health plan, corporate, state, and federal regulations.

Skills

Healthcare experience

Medical terminology

Multitasking

Communication skills

Education

GED

Bachelor's degree preferred

Tools

TriZetto QNXT

Microsoft Office Suite

SQL

Job description

CVS Health is seeking a Contract Coordinator Analyst to support the Medicaid Network management team in Illinois. You will help ensure contract documentation accuracy, load provider records, and maintain up-to-date information across internal systems.

The role involves reviewing contracts, responding to inquiries, aiding with audits, and ensuring compliance with regulations. A background in healthcare, familiarity with TriZetto QNXT, and strong MS Office skills are essential.