Network Contracts & Data Integrity Specialist

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

Benefits offered by this job

Comprehensive benefits package

Bonus eligibility

Job summary

CVS Health seeks a Network Configuration Specialist to apply in-depth contracting and data audit knowledge to optimize provider networks, while meeting accessibility, quality, and financial goals.

The role entails reviewing, designing, and auditing complex contracts, supporting recruitment, and collaborating on negotiations as needed. Strong Excel/SQL skills and Medicaid experience are required.

Qualifications

• 3-5 years of experience working with Medicaid and claims.
• Demonstrated computer literacy, with the ability to navigate Excel and SQL.
• Ability to work standard business hours from Monday-Friday, Central Standard Time.

Responsibilities

• Assists with establishing and implementing results-based programs for network operations.
• Applies in-depth knowledge to offer feedback for decisions and strategy.
• Implements review, loading, and auditing of complex contracts and fee schedules in contract management systems.
• Conducts routine research and audits to identify issues and propose solutions.
• Coordinates contracting activities and review of contracts pre- and post-signature.

Skills

Medicaid experience

SQL

Microsoft Excel

CST hours

Education

High school diploma or GED

Bachelor’s degree or specialized training/certification

Job description

CVS Health seeks a Network Configuration Specialist to apply in-depth contracting and data audit knowledge to optimize provider networks, while meeting accessibility, quality, and financial goals.

The role entails reviewing, designing, and auditing complex contracts, supporting recruitment, and collaborating on negotiations as needed. Strong Excel/SQL skills and Medicaid experience are required.