Senior Network Contracts & Negotiations Manager

CVS Health; South Carolina; Hybrid; USD 54,000 - 159,000; Full time

Benefits offered by this job

Comprehensive benefits package

Bonus eligibility

Professional development opportunities

Job summary

CVS Health is seeking a seasoned professional to lead contract negotiations with providers in the United States. The role focuses on dispute resolution, performance alignment, and cross-functional collaboration within Aetna-driven markets.

Ideal candidates have extensive provider contracting expertise, experience with ACAS/HRP platforms, and the ability to deliver cost-saving negotiations while guiding junior colleagues. Full-time position with comprehensive benefits and bonus eligibility.

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

• Develop, maintain, and enhance working relationships with physicians/providers and local network and patient management teams in the markets with Aetna.
• Establishes and implements programs and innovative initiatives for the organization to advance Contract Negotiations initiatives.
• Forecasts changes within the Contract Negotiations industry, conducts business impact assessments, and develops modification strategies with the aid of process improvement methodologies.
• Integrates cross-functional collaboration to contribute to provider compensation and pricing development activities and recommendations for negotiations and reimbursement modeling activities.
• Determines recommendations to manage cost issues and support cost-saving initiatives and settlement activities.
• Assists in the management of network development, maintenance, and refinement activities and strategies in support of cross-market network management units.
• Coaches more junior colleagues in techniques, processes, and responsibilities.
• Other duties and responsibilities as assigned by manager.

Skills

Provider contracting

Claims management

Patient management

ACAS/HRP platforms

Education

Bachelors degree

Tools

SCM

Smart Front End

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Contract Inquiry

Job description

CVS Health is seeking a seasoned professional to lead contract negotiations with providers in the United States. The role focuses on dispute resolution, performance alignment, and cross-functional collaboration within Aetna-driven markets.

Ideal candidates have extensive provider contracting expertise, experience with ACAS/HRP platforms, and the ability to deliver cost-saving negotiations while guiding junior colleagues. Full-time position with comprehensive benefits and bonus eligibility.