Provider Network & Contracts Specialist

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

Benefits offered by this job

Comprehensive benefits package

Job summary

CVS Health is hiring a Network Configuration Specialist in Kentucky to enhance provider networks through contract review, data audits, and collaboration with negotiations. The role supports recruitment efforts and ensures accessibility, quality, and financial goals are met.

The position requires 3–5 years with Medicaid/claims, Excel and SQL proficiency, and CST-friendly hours. A bachelor’s degree or specialized training is preferred, with a comprehensive benefits package.

Qualifications

• 3–5 years of experience working with Medicaid and claims.
• Proficient in Microsoft Excel and SQL.
• Ability to work standard business hours from Monday-Friday, supporting Central Standard Time.
• Bachelor's degree or specialized training/certification.

Responsibilities

• Assists with establishing and implementing results-based programs for the network operations area.
• Applies in-depth knowledge to offer feedback for decisions and innovation strategies.
• Implements review, design, loading, and auditing of complex contracts and fee schedules in contract management systems.
• Conducts routine research and audits to protect data, contract integrity, and performance.
• Coordinates contracting activities and pre- and post-signature review of contracts and language.
• Coaches junior colleagues in techniques and processes.
• Performs other duties as needed.

Skills

Critical thinking

Collaboration

Problem solving

Education

Bachelor's degree or specialized training/certification

High school diploma or GED

Tools

Excel

SQL

Job description

CVS Health is hiring a Network Configuration Specialist in Kentucky to enhance provider networks through contract review, data audits, and collaboration with negotiations. The role supports recruitment efforts and ensures accessibility, quality, and financial goals are met.

The position requires 3–5 years with Medicaid/claims, Excel and SQL proficiency, and CST-friendly hours. A bachelor’s degree or specialized training is preferred, with a comprehensive benefits package.