Senior Provider Contracting & Network Manager

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

Job summary

CVS Health is seeking a Contracts professional to construct, execute, and review provider contracts in the United States, ensuring alignment with accessibility, quality, and financial goals. You will lead negotiations, manage disputes, and support cost-saving settlements within a cross-functional team.

The role emphasizes collaboration with physicians/providers, network teams, and patient management, leveraging 5+ years of contracting/claims experience and familiarity with ACAS/HRP platforms.

Qualifications

• 5+ years in provider contracting, claims management, or patient management.
• 5+ years working in a Claims environment.
• 5+ years using ACAS and HRP claim platforms, products, and provider relations.

Responsibilities

• Negotiate, execute, review, and analyze contracts with providers.
• Deliver dispute resolution and settlement negotiations with providers.
• Forecast changes in the Contract Negotiations industry and assess business impact.

Skills

Provider contracting

Claims management

ACAS/HRP platforms

Education

Bachelor's degree

Tools

SCM (Aetna)

Smart Front End

Rate Inquiry

Contract Inquiry

Job description

CVS Health is seeking a Contracts professional to construct, execute, and review provider contracts in the United States, ensuring alignment with accessibility, quality, and financial goals. You will lead negotiations, manage disputes, and support cost-saving settlements within a cross-functional team.

The role emphasizes collaboration with physicians/providers, network teams, and patient management, leveraging 5+ years of contracting/claims experience and familiarity with ACAS/HRP platforms.