Negotiator Analyst (Level I) at CVS Health

, , United States -

Full Time

Start Date

Immediate

Expiry Date

02 Jan, 26

Salary

102081.0

Posted On

04 Oct, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Negotiation, Medical Claims, Benchmarking Costs, Mathematical Skills, Written Skills, Verbal Skills, Coding Experience, CMS, CPC Certification, Usual and Customary Calculations, Cost-Benchmarking, Documentation Processes, Outbound Communications, Provider Contacts, Production Metrics

Industry

Hospitals and Health Care

Description

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 Summary The Negotiator Analyst is responsible for negotiating out-of-network (OON) medical claims valued at $10,000 and above. This role involves learning the negotiation role, and understanding (U&C) calculated rates and benchmarking of medical costs. The individual will be developing their role as a negotiator, working with training staff, and team members as more complex cases and strategies are developed. What you will do Learn to navigate the systems, and create networking, for this role Develop filing, naming conventions, and documentation processes Conduct checklist workups and manage outbound communications via phone, fax, and email to facilitate negotiations. Work up and organize daily cases Make outbound calls, develop provider contacts, and understand production metrics Required Qualifications 3-5 years of experience in a medical claim background with demonstrated ability and strong understanding of benchmarking costs for medical services, supplies, and drugs. Previous medical provider/business office phone call handling history. Strengths in mathematical, written, and verbal skills. Preferred Qualifications Coding experience, CMS, and/or CPC Certification. Proficient in Usual and Customary (calculations) and cost-benchmarking for drugs, supplies, and services. Education Associates/High School graduate, or equivalent professional work experience. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $43,888.00 - $102,081.00 This 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 people We 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 https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will close on: 10/17/2025 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area.

Responsibilities

The Negotiator Analyst is responsible for negotiating out-of-network medical claims valued at $10,000 and above. This role involves learning the negotiation process and understanding calculated rates and benchmarking of medical costs.