Senior Provider Network Contracting Manager - Medicaid at CVS Health

, Kymenlaakso, United States -

Full Time

Start Date

Immediate

Expiry Date

25 Mar, 26

Salary

149328.0

Posted On

25 Dec, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Provider Contracting, Provider Relations, Medicaid, Behavioral Health, Communication, Critical Thinking, Project Management, Problem Solving, Negotiation, Microsoft Applications

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 Reviews, analyzes, negotiates, and executes complex Medicaid contracts with health systems, physician groups, and behavioral health providers in accordance with company standards to maintain and enhance provider networks while meeting and exceeding accessibility, compliance, quality, and financial goals and cost initiatives. Collaborates cross-functionally to develop provider compensation and pricing strategies and manages contracts through language and compliance reviews. Serves as a liaison to internal colleagues to interpret contracts, drive cost savings, resolve claims and other service issues. Required Qualifications A minimum of 3 years work experience in a provider contracting or provider relations role, Medicaid and/or behavioral health experience preferred. Proven working knowledge of physician reimbursement methodologies and contracting strategies. Strong communication, critical thinking, project management and problem-solving skills. A willingness to actively interact with providers and have complex conversations. Working knowledge of Microsoft applications. Adept at negotiating complex healthcare provider contracts Preferred Qualifications Working knowledge of QuickBase, QNEXT, PRMS and KIT systems preferred. Education Bachelor's degree preferred or a combination of professional work experience and education. Pay Range The typical pay range for this role is: $67,900.00 - $149,328.00 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. This position also includes an award target in the company’s equity award program. 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: 01/10/2026 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 role involves reviewing, analyzing, negotiating, and executing complex Medicaid contracts to enhance provider networks. It also includes collaborating cross-functionally to develop compensation strategies and managing contracts.