Network Contracts & Data Configuration Specialist

CVS Health; California (MO); Hybrid; USD 47,000 - 122,000; 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 Network Configuration Specialist to enhance provider networks by auditing contracts and data while aligning with accessibility, compliance, quality, and financial goals.

You will review complex contracts, support recruitment, and collaborate on negotiations, using Excel and SQL to analyze data. This full-time role requires 3-5 years in Medicaid/claims and a Bachelor’s degree or equivalent training.

Qualifications

• 3-5 years of experience working with Medicaid and claims.
• Proficient in Microsoft Excel and SQL.
• Ability to work standard US Central Time business hours.

Responsibilities

• Assist with establishing and implementing results-based programs for network operations.
• Apply in-depth knowledge to provide feedback for decisions and strategy.
• Design, loading, and auditing of complex contracts and fee schedules in contract management systems.
• Conduct routine research and audits to identify issues and propose solutions.
• Provide technical guidance on contracting and related systems.

Skills

Medicaid knowledge & claims

Microsoft Excel

SQL

CST work hours (US Central)

Education

Bachelor's degree or specialized training/certification

Job description

CVS Health is seeking a Network Configuration Specialist to enhance provider networks by auditing contracts and data while aligning with accessibility, compliance, quality, and financial goals.

You will review complex contracts, support recruitment, and collaborate on negotiations, using Excel and SQL to analyze data. This full-time role requires 3-5 years in Medicaid/claims and a Bachelor’s degree or equivalent training.