National Network Contracts Manager – Health Providers

CVS Health; Virginia; Hybrid; USD 54,000 - 159,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health in the United States is seeking an experienced contract professional to construct, negotiate, and analyze contracts with providers. The role focuses on dispute resolution, settlement negotiations, and ensuring contracts meet accessibility, quality, financial, and cost goals.

Responsibilities include building relationships with physicians/providers, advancing negotiation initiatives, and collaborating with cross-functional teams on provider compensation and pricing models.

Qualifications

• 5+ years of provider contracting, claims management, or patient management experience.
• 5+ years experience working with or in a Claims environment.
• 5+ years experience that includes ACAS and HRP claim platforms, products, and benefits; patient management, provider relations, or claims management.

Responsibilities

• Constructs negotiation, execution, review, and analysis of contracts.
• Delivers dispute resolution and settlement negotiations with providers.
• Ensures contract performance aligns with accessibility, compliance, quality, financial, and cost goals.
• Integrates cross-functional collaboration to contribute to provider compensation and pricing development activities and recommendations for negotiations and reimbursement modeling activities.
• Determines recommendations to manage cost issues and support cost-saving initiatives and settlement activities.
• Assists in the management of network development, maintenance, and refinement activities and strategies in support of cross-market network management units.
• Coaches more junior colleagues in techniques, processes, and responsibilities.
• Other duties and responsibilities as assigned by manager.

Skills

Provider contracting

Claims management

Patient management

ACAS and HRP platforms

Education

Bachelor's degree

Tools

SCM

Smart Front End

Rate Inquiry

Contract Inquiry

Job description

CVS Health in the United States is seeking an experienced contract professional to construct, negotiate, and analyze contracts with providers. The role focuses on dispute resolution, settlement negotiations, and ensuring contracts meet accessibility, quality, financial, and cost goals.

Responsibilities include building relationships with physicians/providers, advancing negotiation initiatives, and collaborating with cross-functional teams on provider compensation and pricing models.