Senior Network Contract & Provider Relations Manager

CVS Health; Sacramento (CA); On-site; USD 54,000 - 159,000; Full time

Job summary

CVS Health is seeking a Contract Negotiations professional to lead negotiation, execution, and review of contracts with providers and networks. You will deliver dispute resolution and settlement negotiations while ensuring performance aligns with accessibility, quality, and financial goals.

Ideal candidates have 5+ years in provider contracting or claims, familiarity with ACAS/HRP platforms, and a background in cross-functional collaboration across providers and management teams.

Qualifications

• 5+ years of provider contracting, claims management, or patient management experience.
• 5+ experience working with/or in a Claims environment.
• 5+ experience that includes ACAS and HRP claim platforms, products, and benefits; patient management, provider relations, or claims management.

Responsibilities

• Constructs negotiation, execution, review, and analysis of contracts.
• Delivers dispute resolution and settlement negotiations with providers.
• Ensures contract performance aligns with accessibility, compliance, quality, financial, and cost goals.
• Integrates cross-functional collaboration to contribute to provider compensation and pricing development activities.
• Assists in network development, maintenance, and refinement activities and strategies.
• Coaches more junior colleagues in techniques, processes, and responsibilities.

Skills

Provider contracting

Claims management

Patient management

ACAS/HRP familiarity

Education

Bachelor's degree

Tools

ACAS/HRP platforms

Job description

CVS Health is seeking a Contract Negotiations professional to lead negotiation, execution, and review of contracts with providers and networks. You will deliver dispute resolution and settlement negotiations while ensuring performance aligns with accessibility, quality, and financial goals.

Ideal candidates have 5+ years in provider contracting or claims, familiarity with ACAS/HRP platforms, and a background in cross-functional collaboration across providers and management teams.