Network Contracts & Data Integrity Specialist

CVS Health; Washington (District of Columbia); Hybrid; USD 47,000 - 122,000; Full time

Benefits offered by this job

Bonus eligibility

Job summary

CVS Health, based in the Washington area, seeks a Network Configuration Specialist to audit contracts and manage provider networks, ensuring accessibility, quality and cost goals. The role emphasizes data review, design and auditing of complex contracts, and collaboration with recruitment and negotiations.

Requirements include 3–5 years Medicaid/claims experience, proficiency in Excel and SQL, and CST business hours.

Qualifications

• 3–5 years of Medicaid and claims experience.
• Proficiency in Microsoft Excel and SQL/data tools.
• Ability to work standard business hours from Monday-Friday, Central Standard Time.
• Experience navigating internal/external systems and providing data-driven insights.

Responsibilities

• Assists with establishing and implementing results-based programs for network operations.
• Offers feedback to inform decisions and innovation strategies for growth and visibility.
• Implements review, design, loading, and auditing of contracts and fee schedules in contract systems.
• Conducts routine research, analysis, and audits to protect data, contract integrity, and performance.
• Provides technical expertise for contracting questions and related systems information.
• Coordinates contracting activities and documentation, including pre- and post-signature review.
• Coaches junior colleagues in techniques and processes.
• Performs other duties as needed.

Skills

Medicaid experience

Excel

SQL

CST hours availability

Education

Bachelor's degree or relevant training

High school diploma

Tools

SQL

Job description

CVS Health, based in the Washington area, seeks a Network Configuration Specialist to audit contracts and manage provider networks, ensuring accessibility, quality and cost goals. The role emphasizes data review, design and auditing of complex contracts, and collaboration with recruitment and negotiations.

Requirements include 3–5 years Medicaid/claims experience, proficiency in Excel and SQL, and CST business hours.