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Provider Contract Negotiation Manager

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States

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Category:
-

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Contract Type:
Not provided

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Salary:

54300.00 - 145860.00 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.

Job Responsibility:

  • Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with solo, small group, or local providers
  • Manages contract performance in support of network quality, availability, and financial goals and strategies
  • Recruits providers as needed to ensure attainment of network expansion goals, achieve regulatory and/or internal adequacy targets
  • Collaborates cross-functionally to contribute to provider compensation and pricing development activities and recommendations, submission of contractual information, and the review and analysis of reports as part of negotiation and reimbursement modeling activities
  • Provides Subject Matter Expert support for questions related to recruitment initiatives, contracting, provider issues/resolutions, related systems and information contained
  • Provide guidance and share expertise to others on the team
  • Responsible for identifying and making recommendations to manage cost issues and supporting cost saving initiatives and/or settlement activities
  • Provides network development, maintenance, and refinement activities and strategies in support of cross-market network management unit
  • Assists with the design, development, management, and or implementation of strategic network configurations, including integration activities
  • May optimize interaction with assigned providers and internal business partners to manage 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 related experience, proven and proficient negotiating skills
  • Proven working knowledge of competitor strategies, complex contracting options, financial/contracting arrangements, and regulatory requirements
  • Must reside in the Pacific Northwest market (Washington, Oregon, Alaska, or Idaho)
  • 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
  • Highly organized and self-driven
  • Bachelor's degree preferred

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:
February 25, 2026

Expiration:
April 04, 2026

Employment Type:
Fulltime
Work Type:
Remote work
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