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.
Position Summary
Constructs negotiation, execution, review, and analysis of contracts. Delivers dispute resolution and settlement negotiations with providers. Ensures contract performance aligns with accessibility, compliance, quality, financial, and cost goals.
What you will do
Negotiate single case agreements for episodes of care on a pre-service basis.
- Participation/engagement of looking at forecasts changes within the Contract Negotiations industry, development of business impact assessments, and modification strategies with the aid of process improvement methodologies.
- Determines recommendations to manage cost issues and support cost-saving initiatives and settlement activities
- Develop, maintain, and enhance working relationships with physicians/providers and local network and patient management teams in the markets within Aetna.
- Coaches more junior colleagues in techniques, processes, and responsibilities.
Required Qualifications
- 2+ years of experience in provider contracting, claims management or patient management.
- 2+ years’ experience working with/or in a Claims environment.
- 1-2 years’ experience that includes ACAS and HRP claim platforms, products, and benefits; patient management; provider relations or claims management.
- This is a remote position
Preferred Qualifications
- Knowledge/experience with National Advantage Program within Aetna.
- Aetna systems (Smart Front End, ASD, ATV, HRP, MedCompass. RUMBA – EPDB, EWMP, Rate Inquiry, Contract Inquiry)
Education
Bachelor's Degree or equivalent years of experience
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$54,300.00 - $145,860.00This 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 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: 03/31/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Top Skills
What We Do
CVS Health is the leading health solutions company that delivers care in ways no one else can. We reach people in more ways and improve the health of communities across America through our local presence, digital channels and our nearly 300,000 dedicated colleagues – including more than 40,000 physicians, pharmacists, nurses and nurse practitioners.
Wherever and whenever people need us, we help them with their health – whether that’s managing chronic diseases, staying compliant with their medications, or accessing affordable health and wellness services in the most convenient ways. We help people navigate the health care system – and their personal health care – by improving access, lowering costs and being a trusted partner for every meaningful moment of health. And we do it all with heart, each and every day.
