Payor Relations & Contracting Manager

4062 Aetna Resources, LLC; Kentucky; On-site; USD 60,000 - 133,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Other benefits

Job summary

CVS Health is seeking a Manager of Contract Negotiation to lead provider contracts and relationships in the Northern Ohio market. You will oversee negotiation and execution, ensure implementation of negotiated terms, and monitor performance against accessibility, quality, and cost objectives.

The role requires 5 years in healthcare administration or health insurance operations and 3+ years managing provider relationships.

Qualifications

• 5 years of experience in healthcare administration or health insurance operations.
• 3+ years managing provider relationships and contract management.
• Demonstrated ability to collaborate with internal and external stakeholders to identify root causes and drive timely solutions.
• Proficiency in Microsoft Word, Excel, and PowerPoint.

Responsibilities

• Lead development and execution of innovative programs to advance contract negotiation initiatives.
• Anticipate industry changes, evaluate impact, and formulate strategic responses.
• Design and implement systems to recruit providers and support network expansion.
• Conduct competitive analyses to inform reimbursement strategies.
• Foster cross-functional collaboration to enhance provider compensation methodologies and analyze financial impacts.
• Recommend strategies to address cost challenges and drive cost-saving initiatives.
• Support network development, maintenance, and optimization to meet company and market objectives.
• Mentor colleagues on best practices, processes, and responsibilities.

Skills

Healthcare administration

Provider relations

Contract management

Data analysis

Microsoft Office

Education

Bachelor's degree

Tools

EPDB

Strategic Contract Manager (SCM)

Provider Data Management

Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Position Summary

This is an individual contributor role. The Manager of Contract Negotiation develops and maintains strategic relationships with physician partners across the Northern Ohio market, leading contract management and provider relations initiatives that support Commercial and Medicare lines of business. In addition to managing these relationships, the Manager develops, reviews, analyzes, and executes provider contracts. They ensure proper implementation of negotiated agreements and monitor contract performance to align with accessibility, compliance, quality, financial, and cost objectives.

Key Responsibilities

• Lead the development and execution of innovative programs to advance contract negotiation initiatives across the organization.
• Anticipate industry changes, evaluate their impact, and formulate strategic responses.
• Design and implement systems to recruit providers, supporting network expansion and adequacy goals.
• Conduct competitive analyses to inform reimbursement strategies.
• Foster cross-functional collaboration to enhance provider compensation methodologies and analyze financial impacts of reimbursement models.
• Recommend strategies to address cost challenges and drive cost‑saving initiatives and settlement activities.
• Support network development, maintenance, and optimization to achieve company and market objectives.
• Mentor colleagues on best practices, processes, and responsibilities to strengthen team capabilities.

Required Qualifications

• 5 years of experience leading or supporting operational functions within healthcare administration or health insurance environments.
• 3+ years managing provider relationships and overseeing contract management functions.
• Demonstrated ability to partner with internal and external stakeholders to identify root causes, develop solutions, and drive issue resolution within established timelines.
• Proficiency in Microsoft Word, Excel, and PowerPoint.

Preferred Qualifications

• 3+ years experience with provider contract negotiation or provider relations experience
• Experience with EPDB (Enterprise Provider Database, SCM (Strategic Contract Manager), and Provider Data Management.
• Experience with Commercial and Medicare lines of business.
• Exceptional written and verbal communication skills, particularly with external stakeholders.
• Strong critical thinking, problem-solving, and interpersonal skills.
• Candidates residing in Ohio are strongly preferred.

Education

Bachelor’s degree or equivalent combination of education and professional work experience.

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is: $60,300.00 - $132,600.00 This pay range represents the base hourly rate or base annual full‑time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short‑term incentive program in addition to the base pay range listed above.

Great benefits for great people

• medical, dental, and vision coverage
• paid time off
• retirement savings options
• wellness programs
• other resources, based on eligibility

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 11/13/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Our Work Experience is the combination of everything that’s unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it’s our people. Our employees are self‑disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.