Provider Network Architect

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

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Job summary

CVS Health is seeking a Network Configuration Specialist to improve provider networks through data audits, contract management, and collaborative negotiations. The role focuses on reviews of contracts, data integrity, and supporting network optimization.

The position requires 3–5 years of Medicaid/claims experience, strong Excel and SQL skills, and the ability to work standard hours in CST. A bachelor's or equivalent credential is preferred, with a comprehensive benefits package offered.

Qualifications

• 3–5 years of experience working with Medicaid and claims.
• Proficient in Excel and SQL for data audits and analysis.
• Able to work standard business hours CST/Middle etc.

Responsibilities

• Assist with establishing and implementing results-based programs for network operations.
• Audit and design complex contracts and fee schedules in contract management systems.
• Coordinate contracting activities and documentation, including pre- and post-signature reviews.
• Coach junior colleagues in techniques and processes.

Skills

Medicaid & claims experience

Data analysis

Education

Bachelor or equivalent

High school diploma or GED

Tools

Microsoft Excel

SQL

Job description

CVS Health is seeking a Network Configuration Specialist to improve provider networks through data audits, contract management, and collaborative negotiations. The role focuses on reviews of contracts, data integrity, and supporting network optimization.

The position requires 3–5 years of Medicaid/claims experience, strong Excel and SQL skills, and the ability to work standard hours in CST. A bachelor's or equivalent credential is preferred, with a comprehensive benefits package offered.