Provider Network Configuration & Data Analytics Specialist

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

Benefits offered by this job

Bonus eligibility

Benefits package

Job summary

CVS Health is seeking a Network Configuration Specialist to apply contracting insight and data audits to strengthen provider networks while meeting accessibility, quality and cost goals. The role conducts review, design, and auditing of complex contracts and supports negotiations.

Responsibilities include implementing network contracting processes, analyzing claims and contracts, and coaching junior staff. A Bachelor's degree and Medicaid/claims experience are preferred, with strong Excel and

Qualifications

• 3–5 years of Medicaid and claims experience.
• Proficient in Microsoft Excel and SQL.
• Bachelor's degree or equivalent training/certification.

Responsibilities

• Assist with establishing result-based programs for network operations.
• Apply in-depth knowledge to support decisions and innovation strategies.
• Design, loading, and auditing of complex contracts and fee schedules.
• Conduct routine research and audits to protect data and contract integrity.
• Provide technical expertise on contracting systems.
• Coordinate complex contracting activities and post-signature reviews.
• Coach junior colleagues in techniques and responsibilities.
• Perform other duties as needed.

Skills

Medicaid experience

Claims processing

Excel

SQL

Education

Bachelor's degree

Job description

CVS Health is seeking a Network Configuration Specialist to apply contracting insight and data audits to strengthen provider networks while meeting accessibility, quality and cost goals. The role conducts review, design, and auditing of complex contracts and supports negotiations.

Responsibilities include implementing network contracting processes, analyzing claims and contracts, and coaching junior staff. A Bachelor's degree and Medicaid/claims experience are preferred, with strong Excel and