Strategic Network Contracts Manager

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

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking an experienced professional to construct and manage contract negotiations, dispute resolution, and performance alignment across provider networks in the United States. You will work with physicians, local management teams, and cross-functional partners to implement innovative negotiation initiatives and cost-saving strategies.

Required are 5+ years in provider contracting or claims management, with familiarity in ACAS/HRP platforms. Bachelor’s degree preferred.

Qualifications

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

Responsibilities

• Develop and maintain relationships with physicians/providers and local network teams.
• Establish programs for contract negotiations and initiatives.
• Forecast changes in contract negotiations; assess business impact and plan modifications.
• Collaborate cross-functionally on provider compensation and pricing for negotiations and reimbursement modeling.
• Recommend actions to manage cost issues and support settlement activities.
• Assist in network development, maintenance, and refinement across markets.
• Coach junior colleagues on techniques, processes, and responsibilities.
• Perform other duties as assigned by the manager.

Skills

Provider contracting

Contract negotiations

Dispute resolution

Education

Bachelor's degree preferred

Tools

ACAS

HRP

Contract Inquiry

Rate Inquiry

Smart Front End

SCM

Job description

CVS Health is seeking an experienced professional to construct and manage contract negotiations, dispute resolution, and performance alignment across provider networks in the United States. You will work with physicians, local management teams, and cross-functional partners to implement innovative negotiation initiatives and cost-saving strategies.

Required are 5+ years in provider contracting or claims management, with familiarity in ACAS/HRP platforms. Bachelor’s degree preferred.