Network Contracts & Data Specialist

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

Job summary

CVS Health is seeking a Network Configuration Specialist to apply in-depth knowledge of contracting initiatives and data audits to enhance provider networks while meeting accessibility, compliance, quality, and financial goals.

The role involves reviewing, designing, loading, and auditing complex contracts and fee schedules, supporting recruitment, and collaborating on negotiations as needed. Strong Excel/SQL skills and Medicaid experience are essential.

Qualifications

• 3–5 years of experience with Medicaid and claims.
• Proficient in Microsoft Excel and SQL.
• Ability to work standard CST business hours.
• Bachelor's degree or equivalent training.

Responsibilities

• Assist with results-based programs for the network operations area.
• Apply in-depth knowledge to feedback decisions and innovation strategies.
• Design, load, and audit complex contracts, amendments, and fee schedules.
• Conduct routine research and audits to identify issues and propose solutions.
• Provide technical expertise for questions regarding contracting systems.
• Coordinate contracting activities and pre-/post-signature reviews.
• Coach junior colleagues in techniques, processes and responsibilities.
• Perform other duties as needed.

Skills

Medicaid experience

SQL

Excel

Time management

Education

Bachelor's degree or equivalent

High school diploma

Job description

CVS Health is seeking a Network Configuration Specialist to apply in-depth knowledge of contracting initiatives and data audits to enhance provider networks while meeting accessibility, compliance, quality, and financial goals.

The role involves reviewing, designing, loading, and auditing complex contracts and fee schedules, supporting recruitment, and collaborating on negotiations as needed. Strong Excel/SQL skills and Medicaid experience are essential.