Strategic Network Contracts Lead – Health Systems

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

Benefits offered by this job

Comprehensive benefits package

Bonus and incentive eligibility

Job summary

CVS Health is seeking a seasoned Contracts professional to construct, negotiate, and analyze contracts, and to drive dispute resolution with providers. You will ensure performance aligns with accessibility, quality, and financial goals while coordinating with network teams in markets served by CVS Health and Aetna.

The role emphasizes cross-functional collaboration, cost improvement initiatives, and development of negotiation strategies.

Qualifications

• 5+ years of provider contracting experience.
• 5+ years experience in a Claims environment.
• 5+ experience with ACAS and HRP claim platforms, products, and benefits.

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 working relationships with physicians/providers and local network and patient management teams in the markets with Aetna.
• Forecasts changes within the Contract Negotiations industry and develops modification strategies.
• Integrates cross-functional collaboration to contribute to provider compensation and pricing development activities and recommendations for negotiations and reimbursement modeling.

Skills

Provider contracting

Claims management

Patient management

ACAS & HRP platforms

Cross-functional collaboration

Education

Bachelor's degree

Tools

Aetna SCM

Smart Front End

Rate Inquiry

Contract Inquiry

Job description

CVS Health is seeking a seasoned Contracts professional to construct, negotiate, and analyze contracts, and to drive dispute resolution with providers. You will ensure performance aligns with accessibility, quality, and financial goals while coordinating with network teams in markets served by CVS Health and Aetna.

The role emphasizes cross-functional collaboration, cost improvement initiatives, and development of negotiation strategies.