Network Configuration & Contracts Specialist

CVS Health; Massachusetts; Hybrid; USD 47,000 - 122,000; Full time

Job summary

CVS Health is seeking a Network Configuration Specialist to apply in-depth contracting and data audit knowledge to enhance provider networks while meeting accessibility, quality, and financial goals. The role involves reviewing, designing, loading, and auditing complex contracts and fee schedules in contract management systems.

You will support recruitment efforts, participate in negotiations as needed, coach junior colleagues, and collaborate with cross-functional teams to protect data

Qualifications

• 3–5 years of Medicaid and claims experience.
• Proficient in Microsoft Excel and SQL.
• Ability to work standard business hours CST Monday–Friday.
• Bachelor's degree or specialized training/certification (preferred).

Responsibilities

• Assists with establishing and implementing results-based programs for network operations.
• Applies in-depth knowledge to offer feedback for decisions and strategies to enhance growth.
• Implements review, design, loading, and auditing of complex contracts and fee schedules in contract management systems.
• Conducts routine research, analysis, and audits to protect data, contract integrity, and performance.
• Provides technical expertise for contracting questions and related systems.

Skills

Medicaid experience

Claims processing

Communication skills

Education

High school diploma or GED

Tools

Microsoft Excel

SQL

Job description

CVS Health is seeking a Network Configuration Specialist to apply in-depth contracting and data audit knowledge to enhance provider networks while meeting accessibility, quality, and financial goals. The role involves reviewing, designing, loading, and auditing complex contracts and fee schedules in contract management systems.

You will support recruitment efforts, participate in negotiations as needed, coach junior colleagues, and collaborate with cross-functional teams to protect data