National Provider Contract & Network Management Lead

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

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a seasoned Contract Negotiations professional to construct, negotiate, and review contracts with providers, ensuring alignment with accessibility, quality, financial, and cost goals. You will deliver dispute resolution and settlement negotiations while maintaining strong relationships with physicians, local networks, and patient management teams.

Ideal candidates have 5+ years in provider contracting or claims, familiarity with ACAS/HRP platforms, and a Bachelor's degree

Qualifications

• 5+ years in provider contracting, claims management, or patient management.
• Experience in a Claims environment with ACAS/HRP platforms.
• Bachelor’s degree preferred or equivalent work experience.

Responsibilities

• Construct, negotiate, and review contracts with providers.
• Deliver dispute resolution and settlement negotiations with providers.
• Ensure contract performance aligns with accessibility, quality, and cost goals.
• Develop and maintain relationships with physicians/providers and local networks.
• Lead cross-functional collaboration in provider compensation and pricing.
• Coach junior colleagues in techniques and processes.

Skills

Provider contracting

Claims management

ACAS/HRP platforms

Education

Bachelor's degree

Tools

Aetna SCM

Smart Front End

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Contract Inquiry

Job description

CVS Health is seeking a seasoned Contract Negotiations professional to construct, negotiate, and review contracts with providers, ensuring alignment with accessibility, quality, financial, and cost goals. You will deliver dispute resolution and settlement negotiations while maintaining strong relationships with physicians, local networks, and patient management teams.

Ideal candidates have 5+ years in provider contracting or claims, familiarity with ACAS/HRP platforms, and a Bachelor's degree