Provider Contract Negotiator & Network Strategy Lead

CVS Health; Town of Florida (NY); Hybrid; USD 54,000 - 159,000; Full time

Benefits offered by this job

Comprehensive benefits

Bonus eligibility

401(k) plan

Paid time off

Job summary

CVS Health in the New York area seeks an experienced contract professional to construct negotiation, execution, review, and analysis of contracts with providers and networks.

The role delivers dispute resolution and settlement negotiations, supports cost-saving initiatives, and collaborates with cross-functional teams to align contracts with accessibility, compliance, and quality goals.

Qualifications

• 5+ years of provider contracting, claims management, or patient management experience.
• 5+ years experience in a Claims environment.
• 5+ experience with 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.
• Forecasts changes within the Contract Negotiations industry and develops modification strategies.
• Integrates cross-functional collaboration to support provider compensation and pricing development.

Skills

Provider contracting

Claims management

Dispute resolution

Negotiation

Cross-functional collaboration

Education

Bachelor's degree

Tools

ACAS

HRP

SCM

Smart Front End

Rate Inquiry

Contract Inquiry

Job description

CVS Health in the New York area seeks an experienced contract professional to construct negotiation, execution, review, and analysis of contracts with providers and networks.

The role delivers dispute resolution and settlement negotiations, supports cost-saving initiatives, and collaborates with cross-functional teams to align contracts with accessibility, compliance, and quality goals.