National Network Contracts & Negotiations Manager

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

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Wellness programs

Bonus eligibility

Job summary

CVS Health is seeking a contracts professional to lead negotiation, execution, and review of provider contracts. You will manage disputes and ensure alignment with accessibility, quality, and financial goals while building strong relationships with physicians, network teams, and patient management in markets with Aetna.

The role emphasizes cross-functional collaboration and strategies for cost-saving and reimbursement modeling, with a strong focus on accurate provider compensation planning and

Qualifications

• 5+ years of provider contracting, claims management, or patient management experience.
• 5+ experience working with/in a Claims environment.
• 5+ 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.
• Develop, maintain, and enhance relationships with physicians/providers and local network and patient management teams in markets with Aetna.
• Establishes and implements programs for Contract Negotiations initiatives.
• Forecasts changes in Contract Negotiations, conducts impact assessments, and develops modification strategies.
• Integrates cross-functional collaboration for provider compensation and pricing development activities.

Skills

Provider contracting

Claims management

Patient management

ACAS HRP

Provider relations

Education

Bachelor's degree

Tools

SCM

Smart Front End

Rate Inquiry

Contract Inquiry

Job description

CVS Health is seeking a contracts professional to lead negotiation, execution, and review of provider contracts. You will manage disputes and ensure alignment with accessibility, quality, and financial goals while building strong relationships with physicians, network teams, and patient management in markets with Aetna.

The role emphasizes cross-functional collaboration and strategies for cost-saving and reimbursement modeling, with a strong focus on accurate provider compensation planning and