Strategic Network Contracts Manager

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

Job summary

CVS Health is seeking a Contracts professional to lead negotiation, execution, and analysis of contracts with providers. You will drive dispute resolution, ensure performance aligns with accessibility, quality, and cost goals, and partner with local networks to optimize outcomes.

The role requires 5+ years in provider contracting or claims, experience with ACAS/HRP platforms, and a Bachelor's degree. It is a full-time, on-site position in Mississippi with a comprehensive benefits package and

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

• 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

Patient management

ACAS/HRP platforms

Cross-functional collaboration

Education

Bachelor's degree

Tools

SCM

Smart Front End

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Contract Inquiry

Job description

CVS Health is seeking a Contracts professional to lead negotiation, execution, and analysis of contracts with providers. You will drive dispute resolution, ensure performance aligns with accessibility, quality, and cost goals, and partner with local networks to optimize outcomes.

The role requires 5+ years in provider contracting or claims, experience with ACAS/HRP platforms, and a Bachelor's degree. It is a full-time, on-site position in Mississippi with a comprehensive benefits package and