Strategic Provider Contract Manager | National Network

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

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Contract Negotiations professional to construct, execute, review, and analyze contracts with providers and networks. The role emphasizes dispute resolution, cost control, and alignment with accessibility, quality, and financial goals.

The candidate will advance contract negotiations, engage in cross-functional teams, and support network management programs across markets. The position is full-time in Oregon with a 40-hour workweek and eligible for CVS Health bonus

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.
• Bachelor's degree preferred or a combination of work experience and education.

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

Contract negotiation

Claims management

Provider relations

Cross-functional collaboration

Data analysis

Education

Bachelor's degree

Tools

ACAS

HRP

SCM

Smart Front End

Rate Inquiry

Contract Inquiry

Job description

CVS Health is seeking a Contract Negotiations professional to construct, execute, review, and analyze contracts with providers and networks. The role emphasizes dispute resolution, cost control, and alignment with accessibility, quality, and financial goals.

The candidate will advance contract negotiations, engage in cross-functional teams, and support network management programs across markets. The position is full-time in Oregon with a 40-hour workweek and eligible for CVS Health bonus