At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryNegotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with ancillary providers in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, compliance, quality, and financial goals and cost incentivesManages contract performance in support of network quality, availability, and financial goals and strategiesRecruit providers as needed to ensure attainment of network expansion and adequacy targetsCollaborates cross -functionally to contribute to provider compensation and pricing development activities, recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activitiesIntegrates cross-functional collaboration to contribute to provider compensation and pricing development activities and recommendations for negotiations and reimbursement modeling activities.Identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activitiesProvides ancillary network development, maintenance, and refinement activities and strategies in support of cross-market network management unitAssists with the design, development, management, and/or implementation of strategic network configurations, including integration activitiesOptimizes interaction with assigned providers and internal business partners to manage relationships and ensure providers needs are metEnsures resolution of escalated issues related, but not limited to, claims payment, contract interpretation, and parameters or accuracy of provider contract or demographic informationCoaches more junior colleagues in techniques, processes, and responsibilities.Required Qualifications:Proven working knowledge of competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements3-5 years related experience Commercial HMO, PPO products knowledge3-5 years related experience Medicare and/or Medicaid products knowledgeKnowledge of Kentucky/Ohio networkPreferred Qualifications:Intermediate knowledge of Microsoft Office, specifically Excel and PowerPointA ready business acumen and the ability to balance and articulate competing priorities while making decisionsStrong and persuasive communication skills, especially written communications, with external stakeholdersStrong critical thinking, problem resolution and interpersonal skillsAdept at execution and delivery (planning, delivering, and supporting) skillsAdept at collaboration and teamworkA growth mindset (agility and developing yourself and others) skillsEducationBachelor's Degree or equivalent professional experienceAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$54,300.00 - $119,340.00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great benefits for great peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.For more information, visit anticipate the application window for this opening will close on: 11/28/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Job ID: 498929153
Originally Posted on: 11/2/2025
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