Remote Provider Contract Negotiation Manager

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

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Retirement plan

Paid time off

Job summary

CVS Health is seeking a remote contract negotiator responsible for constructing negotiation, execution, review, and analysis of provider contracts. It delivers dispute resolution and settlements to ensure contract performance aligns with accessibility, compliance, quality, financial, and cost goals.

In this role you will negotiate single case agreements, collaborate with internal teams, mentor junior colleagues, and support cost-saving initiatives across markets.

Qualifications

• 5+ years in provider contracting or claims management.
• 2+ years in claims operations or related environment.
• 1-2 years with ACAS and HRP platforms, claims products, and benefits.

Responsibilities

• Negotiate single case agreements for episodes of care on a pre-service basis.
• Analyze forecast changes and develop impact assessments with process improvements.
• Recommend cost management and settlement strategies to reduce costs.
• Build relationships with physicians/providers and local networks.
• Coach junior colleagues and share best practices.
• Collaborate with internal teams to support negotiations and outcomes.

Skills

Provider contracting

Claims management

Cross-functional collaboration

Mentoring

Education

Bachelor's degree in a related field

Tools

ACAS/HRP platforms

Smart Front End

MedCompass

RUMBA applications

Job description

CVS Health is seeking a remote contract negotiator responsible for constructing negotiation, execution, review, and analysis of provider contracts. It delivers dispute resolution and settlements to ensure contract performance aligns with accessibility, compliance, quality, financial, and cost goals.

In this role you will negotiate single case agreements, collaborate with internal teams, mentor junior colleagues, and support cost-saving initiatives across markets.