Senior Network Contracts & Provider Relations Manager

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

Job summary

CVS Health is seeking a Contract Negotiations professional to construct and manage complex provider contracts and settlements. The role emphasizes collaboration with physicians, networks, and internal teams to align accessibility, quality, and cost goals.

The position requires 5+ years in provider contracting or claims management, with experience in ACAS/HRP platforms. A Bachelor's degree is preferred, and a full-time, on-site schedule in the New Jersey area is supported by comprehensive

Qualifications

• Five or more years of provider contracting, claims management, or patient management experience.
• Experience working in a Claims environment with ACAS and HRP claim platforms, products, and benefits.
• Bachelor's degree preferred or equivalent work experience.

Responsibilities

• Negotiate, execute, review, and analyze contracts with providers.
• Deliver dispute resolution and settlement negotiations while ensuring alignment with accessibility, quality, and cost goals.
• Develop and maintain relationships with physicians, providers, and local network teams in markets with Aetna.
• Lead cross-functional collaboration to support provider compensation and pricing development.
• Forecast market changes and assess business impact to inform modification strategies.
• Coach junior colleagues on processes and responsibilities.

Skills

Provider contracting

Claims management

Patient management

ACAS and HRP platforms

Education

Bachelor's degree

Tools

SCM

Smart Front End

Rate Inquiry

Contract Inquiry

Job description

CVS Health is seeking a Contract Negotiations professional to construct and manage complex provider contracts and settlements. The role emphasizes collaboration with physicians, networks, and internal teams to align accessibility, quality, and cost goals.

The position requires 5+ years in provider contracting or claims management, with experience in ACAS/HRP platforms. A Bachelor's degree is preferred, and a full-time, on-site schedule in the New Jersey area is supported by comprehensive