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Provider Contract Negotiation Manager

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States , Work at Home

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Category:
-

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Contract Type:
Not provided

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Salary:

54300.00 - 119340.00 USD / Year
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Job Description:

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. This position will be managing Mid-South(Cary, NC), which is a priority sales market.

Job Responsibility:

  • Manages contract performance and drives the development and implementation of value-based contract relationships in support of business strategies
  • Recruits providers as needed to ensure attainment of network expansion and adequacy targets
  • Accountable for cost arrangements within defined groups
  • Collaborates cross-functionally to manage provider compensation and pricing development activities, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities
  • Responsible for identifying and managing cost issues and collaborating cross functionally to execute significant cost saving initiatives
  • Represents company with high visibility constituents, including customers and community groups
  • Promotes collaboration with internal partners
  • Evaluates, helps formulate, and implements the provider network strategic plans to achieve contracting targets and manage medical costs through effective provider contracting to meet state contract and product requirements
  • Collaborates with internal partners to assess effectiveness of tactical plan in managing costs
  • May optimize interaction with assigned providers and internal business partners to facilitate relationships and ensure provider needs are met
  • Ensures resolution of escalated issues related, but not limited to, claims payment, contract interpretation and parameters, or accuracy of provider contract or demographic information

Requirements:

  • 3 + years experience with provider contract negotiation or provider relations experience
  • Must reside in North Carolina or South Carolina
  • In-depth knowledge of the managed care industry and practices, as well as a strong understanding of strategies, practices, and financial/contracting arrangements
  • Must possess critical thinking, problem resolution and interpersonal skills
  • Bachelor’s degree and relevant training or work experience

Nice to have:

  • Ability to forge meaningful, long-lasting relationships with providers
  • Knowledge of Medicare programs and related subject matter
What we offer:
  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Colleague assistance programs
  • Tuition assistance
  • Retiree medical access

Additional Information:

Job Posted:
April 05, 2026

Expiration:
April 30, 2026

Employment Type:
Fulltime
Work Type:
Remote work
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