Senior Contract Manager

4062 Aetna Resources, LLC; Illinois; Hybrid; USD 83,000 - 183,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Retirement savings options

Wellness programs

Paid time off

Job summary

CVS Health is seeking a Senior Contract Manager for First Health Network Management in Illinois. This individual contributor role focuses on contracting initiatives, data audits, and provider network improvements to meet accessibility, quality, and financial goals.

You will review, build, and audit complex contracts, collaborate on negotiations, and recruit providers to expand the network while ensuring compliance with NCQA and regulatory standards.

Qualifications

• 7+ years leading complex contracting initiatives.
• 5+ years in healthcare contracting and regulatory contexts.
• Ability to manage priorities, timelines, and budgets.
• Experience influencing cross-functional stakeholders.
• Interaction with providers to support network growth and pricing.
• Knowledge of contract loading, administration, and NCQA concepts.

Responsibilities

• Negotiate, execute, review, and analyze contracts with providers.
• Collaborate cross-functionally on provider compensation and pricing.
• Support network development and improvement initiatives.
• Monitor contract performance in quality, availability, and financial goals.
• Engage in cost-saving initiatives and settlement activities as needed.
• Interpret federal and state regulations and contract requirements.

Skills

Contract management

Data analysis

Cross-functional collaboration

Negotiation

Provider network development

Regulatory compliance

Education

Bachelor's degree

Tools

Microsoft Office Suite

Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritise safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. This is an individual contributor role.

The Senior Contract Manager for First Health Network Management serves as the subject matter expert in support of contracting initiatives and data audits to enhance provider networks while meeting and exceeding accessibility, compliance, quality, and financial goals. Responsible for reviewing, building and auditing complex contract and network data, support recruitment efforts, and collaborating on negotiations as needed.

Role/Responsibilities

Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with solo, small group, or local providers, including SCAs, LOAs, and PPAs. Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities. Responsible for identifying and managing cost issues and collaborating cross functionally to execute significant cost saving initiatives. Represents company with high visibility constituents, including customers and community groups. Promotes collaboration with internal partners. Manages contract performance in support of network quality, availability, and financial goals and strategies. Recruits providers to ensure attainment of network expansion and adequacy targets. Collaborates cross-functionally to contribute to provider compensation and pricing development activities and recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities. Responsible for identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities. Provides network development, maintenance, and refinement activities and strategies in support of cross-market network management unit. Assists with the design, development, management, and or implementation of strategic network configurations, including integration activities. May optimize interaction with assigned providers and internal business partners to manage relationships and ensure provider needs are met. Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information. Interprets contractual requirements including federal and state regulations and NCQA.

Required Qualifications

7+ years of progressive experience leading complex initiatives and delivering measurable business outcomes.

5+ years of working knowledge in the healthcare industry, including competitor strategies, complex contracting options, financial and contracting arrangements, and regulatory requirements.

Demonstrated ability to manage multiple priorities simultaneously while executing against timelines, budgets, and performance objectives.

Proven track record of identifying issues, analyzing data, and making sound decisions to drive operational and financial results.

Experience influencing and partnering with cross-functional stakeholders to achieve shared business goals and enterprise-wide outcomes.

Demonstrated ability to influence across a highly matrixed organization and partner effectively with market stakeholders.

Knowledge of provider contracting systems and contract implementation processes, including contract loading, administration, and compliance oversight.

Strong communication, critical thinking, problem-resolution and interpersonal skills.

Preferred Qualifications

Proficiency in Microsoft Office Suite (e.g., Excel, Word, PowerPoint, Outlook).

Education Bachelor's degree preferred, or a combination of professional work experience and education.

Pay Range

The typical pay range for this role is: $82,940.00 - $182,549.00 This pay range represents the base hourly rate or base annual full‑time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short‑term incentive program in addition to the base pay range listed above. This position also includes an award target in the company’s equity award program.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

We anticipate the application window for this opening will close on: 11/23/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.