Strategic Network Contracts Manager

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

Job summary

CVS Health is seeking a seasoned contracts professional to construct, negotiate, and review contracts with providers. You will deliver dispute resolution and settlements while ensuring performance aligns with accessibility, compliance, quality, and cost goals.

This full-time role requires 5+ years in provider contracting or claims environments, familiarity with ACAS/HRP platforms, and a Bachelor’s degree preferred. The position offers comprehensive benefits and a competitive pay range.

Qualifications

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

Responsibilities

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

Skills

Provider contracting

Claims management

Negotiation

Cross-functional collaboration

Provider relations

Education

Bachelor's degree preferred

Tools

ACAS/HRP platforms

ACAS/HRP systems

Job description

CVS Health is seeking a seasoned contracts professional to construct, negotiate, and review contracts with providers. You will deliver dispute resolution and settlements while ensuring performance aligns with accessibility, compliance, quality, and cost goals.

This full-time role requires 5+ years in provider contracting or claims environments, familiarity with ACAS/HRP platforms, and a Bachelor’s degree preferred. The position offers comprehensive benefits and a competitive pay range.