Strategic Network Contract Manager

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

Job summary

CVS Health is seeking a Contract Negotiations professional to craft, execute, and analyze provider contracts, ensuring alignment with accessibility, quality, and cost goals.

You will build relationships with physicians/providers and local networks, collaborate across teams, and drive initiatives in reimbursement modeling and cost-saving strategies. This is a full-time role with growth opportunities and benefits.

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

Skills

Negotiation

Relationship management

Cross-functional collaboration

Analytical thinking

Process improvement

Education

Bachelor's degree

Tools

ACAS

HRP

SCM

Smart Front End

Rate Inquiry

Contract Inquiry

Job description

CVS Health is seeking a Contract Negotiations professional to craft, execute, and analyze provider contracts, ensuring alignment with accessibility, quality, and cost goals.

You will build relationships with physicians/providers and local networks, collaborate across teams, and drive initiatives in reimbursement modeling and cost-saving strategies. This is a full-time role with growth opportunities and benefits.