Strategic Network Contracts Manager

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

Job summary

CVS Health is seeking a Contract Negotiations professional to construct, review, and analyze provider contracts. You will deliver dispute resolution and settlements with providers and ensure performance aligns with accessibility, compliance, quality, and cost objectives.

Responsibilities include developing programs for the organization, cross-functional collaboration, and supporting negotiation strategies while coaching junior colleagues. 40-hour weeks, full-time role in Massachusetts.

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.
• 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.

Skills

Provider contracting

Claims management

Patient management

Education

Bachelor's degree preferred

Tools

ACAS

HRP

SCM

Smart Front End

Rate Inquiry

Contract Inquiry

Job description

CVS Health is seeking a Contract Negotiations professional to construct, review, and analyze provider contracts. You will deliver dispute resolution and settlements with providers and ensure performance aligns with accessibility, compliance, quality, and cost objectives.

Responsibilities include developing programs for the organization, cross-functional collaboration, and supporting negotiation strategies while coaching junior colleagues. 40-hour weeks, full-time role in Massachusetts.