Strategic Network Contracts Manager

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

Job summary

CVS Health is seeking an experienced contracts professional to construct, negotiate, and review provider contracts. The role focuses on dispute resolution, settlement negotiations with providers, and ensuring contract performance aligns with accessibility, compliance, quality, and cost goals.

The ideal candidate has 5+ years in provider contracting or claims management and familiarity with Aetna’s systems and claim platforms.

Qualifications

• 5+ years of provider contracting, claims management, or patient management experience.
• 5+ years experience working with a Claims environment.
• Experience with 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.
• Analyzes contract performance to ensure accessibility, compliance, quality, financial, and cost goals.
• Integrates cross-functional collaboration for provider compensation and pricing development and reimbursement modeling.
• Determines recommendations to manage cost issues and support cost-saving initiatives and settlement activities.
• Assists in network development, maintenance, and refinement activities and strategies.

Skills

Provider contracting

Education

Bachelor's degree

Tools

ACAS

HRP

Job description

CVS Health is seeking an experienced contracts professional to construct, negotiate, and review provider contracts. The role focuses on dispute resolution, settlement negotiations with providers, and ensuring contract performance aligns with accessibility, compliance, quality, and cost goals.

The ideal candidate has 5+ years in provider contracting or claims management and familiarity with Aetna’s systems and claim platforms.