Senior Network Contracts & Provider Relations Manager

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

Benefits offered by this job

Comprehensive benefits package

Bonus eligibility

Paid time off

Job summary

CVS Health is seeking a Contracts and Negotiations professional to construct, negotiate, and review contracts with providers, ensuring alignment with accessibility, quality, and cost goals while mitigating risk.

This full-time role offers a comprehensive benefits package, bonus eligibility, and a collaborative environment across markets, with opportunities to influence network strategy and reimbursement modeling.

Qualifications

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

Responsibilities

• Negotiate, execute, review, and analyze contracts.
• Deliver dispute resolution and settlements with providers.
• Ensure contract performance aligns with accessibility, quality, financial and cost goals.
• Develop and maintain relationships with physicians/providers and local network teams in markets with Aetna.
• Forecast changes within the Contract Negotiations industry and develop modification strategies.
• Mentor junior colleagues in techniques, processes, and responsibilities.

Skills

Provider contracting

Claims management

Patient management

ACAS

HRP claim platforms

Education

Bachelor's degree

Tools

ACAS

HRP claim platforms

Job description

CVS Health is seeking a Contracts and Negotiations professional to construct, negotiate, and review contracts with providers, ensuring alignment with accessibility, quality, and cost goals while mitigating risk.

This full-time role offers a comprehensive benefits package, bonus eligibility, and a collaborative environment across markets, with opportunities to influence network strategy and reimbursement modeling.