Network Contracts & Provider Relations Manager

CVS Health; Montana; Hybrid; USD 54,000 - 159,000; Full time

Benefits offered by this job

Comprehensive benefits package

Bonus eligibility

Job summary

CVS Health is seeking a Contract Negotiations professional to construct, execute, and review contracts with providers. You will drive dispute resolution and ensure alignment with accessibility, quality, and cost goals across networks.

Responsibilities include developing initiatives for contract negotiations, forecasting industry changes, and collaborating across cross-functional teams on provider compensation and pricing models. Strong ACAS/HRP experience is preferred.

Qualifications

• 5+ years of provider contracting, claims management, or patient management experience.
• 5+ experience working with/or in a Claims environment.
• 5+ experience that includes ACAS and HRP claim platforms, products, and benefits; patient management, provider relations, or claims management.

Responsibilities

• Constructs negotiation, execution, review, and analysis of contracts.
• Delivers dispute resolution and settlement negotiations with providers.
• Ensures contract performance aligns with accessibility, compliance, quality, financial, and cost goals.
• Develop, maintain, and enhance relationships with physicians/providers and local network teams.
• Establishes programs and initiatives for Contract Negotiations.
• Forecasts changes within the Contract Negotiations industry and develops modification strategies.
• Integrates cross-functional collaboration for provider compensation and pricing development.

Skills

Contract negotiations

Claims management

Provider relations

Education

Bachelor's degree

Tools

ACAS

HRP claim platforms

Job description

CVS Health is seeking a Contract Negotiations professional to construct, execute, and review contracts with providers. You will drive dispute resolution and ensure alignment with accessibility, quality, and cost goals across networks.

Responsibilities include developing initiatives for contract negotiations, forecasting industry changes, and collaborating across cross-functional teams on provider compensation and pricing models. Strong ACAS/HRP experience is preferred.