Strategic Provider Contract Manager

CVS Health; Oregon (WI); Hybrid; USD 54,000 - 159,000; Full time

Benefits offered by this job

Bonus eligibility

Comprehensive benefits

Job summary

CVS Health is seeking an experienced professional to lead contract negotiation activities, review and analyze contracts, and deliver dispute resolution with providers. You will ensure performance aligns with accessibility, quality, and cost goals while building strong relationships with physicians, providers, and local management teams.

The role emphasizes cross-functional collaboration, program development for negotiations, and strategic cost management, with a focus on regional markets 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 relationships with physicians/providers and local network and patient management teams.
• Establishes and implements programs and initiatives for contract negotiations.
• Forecasts changes in the contract negotiations landscape and analyzes impact with improvement methods.
• Collaborates cross-functionally on provider compensation and pricing development for negotiations.
• Recommends actions to manage costs and support settlement activities.
• Supports network development, maintenance, and refinement with cross-market units.
• Coaches junior colleagues in techniques and processes.
• Performs other duties as assigned by manager.

Skills

Provider contracting

Claims management

ACAS/HRP platforms

Education

Bachelor's degree preferred

Tools

Aetna systems

Job description

CVS Health is seeking an experienced professional to lead contract negotiation activities, review and analyze contracts, and deliver dispute resolution with providers. You will ensure performance aligns with accessibility, quality, and cost goals while building strong relationships with physicians, providers, and local management teams.

The role emphasizes cross-functional collaboration, program development for negotiations, and strategic cost management, with a focus on regional markets and