Network & Contract Optimization Specialist

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

Benefits offered by this job

Bonus eligible

Comprehensive benefits

Job summary

CVS Health in the United States is seeking a Network Configuration Specialist to apply contracting and data audits to enhance provider networks while meeting accessibility, quality, and financial goals. You will review, design, and audit contracts and fee schedules in contract management systems, support cross-functional negotiations, and coach junior colleagues.

A background in Medicaid/claims, proficiency with Excel and SQL, and the ability to work standard CST hours are preferred; a

Qualifications

• Experience with Medicaid and claims data for network operations.
• Proficiency in Excel and SQL for data analysis and auditing.
• Ability to work CST business hours Monday–Friday.

Responsibilities

• Assist with establishing results-based programs for network operations.
• Apply knowledge to support decisions and innovation strategies.
• Audit and load complex contracts, amendments, and fee schedules.

Skills

Medicaid

Claims data

Microsoft Excel

SQL

CST hours

Education

High school diploma or GED

Bachelor's degree or specialized training/certification

Job description

CVS Health in the United States is seeking a Network Configuration Specialist to apply contracting and data audits to enhance provider networks while meeting accessibility, quality, and financial goals. You will review, design, and audit contracts and fee schedules in contract management systems, support cross-functional negotiations, and coach junior colleagues.

A background in Medicaid/claims, proficiency with Excel and SQL, and the ability to work standard CST hours are preferred; a