National Provider Contracts Manager – Health Network Growth

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

Job summary

CVS Health seeks a seasoned contract professional to lead negotiation and management of contracts with physicians/providers within the CVS Health network. The role focuses on dispute resolution, performance alignment, and cost-control initiatives to support patient access and quality care.

Responsibilities include building cross-functional relations with local networks, driving negotiation programs, and mentoring junior staff, with a 40-hour work week and full-time benefits.

Qualifications

• 5+ years of provider contracting, claims management, or patient management experience.
• 5+ experience working with/or 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.
• Forecasts changes within the Contract Negotiations industry and develops modification strategies.
• Coordinates cross-functional collaboration for provider compensation and pricing development.
• Determines recommendations to manage cost issues and support cost-saving initiatives.
• Assists in network development, maintenance, and refinement activities.
• Coaches junior colleagues in techniques, processes, and responsibilities.

Skills

Provider contracting

Claims management

ACAS & HRP experience

Education

Bachelor's degree

Tools

SCM

Smart Front End

Rate Inquiry

Contract Inquiry

Job description

CVS Health seeks a seasoned contract professional to lead negotiation and management of contracts with physicians/providers within the CVS Health network. The role focuses on dispute resolution, performance alignment, and cost-control initiatives to support patient access and quality care.

Responsibilities include building cross-functional relations with local networks, driving negotiation programs, and mentoring junior staff, with a 40-hour work week and full-time benefits.