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 is an individual contributor role.
The Senior Contract Manager for First Health Network Management serves as the subject matter expert in support of contracting initiatives and data audits to enhance provider networks while meeting and exceeding accessibility, compliance, quality, and financial goals. Responsible for reviewing, building and auditing complex contract and network data, support recruitment efforts, and collaborating on negotiations as needed.
Role/Responsibilities
- Negotiates, executes, reviews, and analyzes contracts and/or handles dispute resolution and settlement negotiations with solo, small group, or local providers, including SCAs, LOAs, and PPAs.
- 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.
- Manages contract performance in support of network quality, availability, and financial goals and strategies.
- Recruits providers to ensure attainment of network expansion and 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.
- 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.
- Interprets contractual requirements including federal and state regulations and NCQA.
Required Qualifications
- 7+ years of progressive experience leading complex initiatives and delivering measurable business outcomes.
- 5+ years of working knowledge in the healthcare industry, including competitor strategies, complex contracting options, financial and contracting arrangements, and regulatory requirements.
- Demonstrated ability to manage multiple priorities simultaneously while executing against timelines, budgets, and performance objectives.
- Proven track record of identifying issues, analyzing data, and making sound decisions to drive operational and financial results.
- Experience influencing and partnering with cross-functional stakeholders to achieve shared business goals and enterprise-wide outcomes.
- Demonstrated ability to influence across a highly matrixed organization and partner effectively with market stakeholders.
- Knowledge of provider contracting systems and contract implementation processes, including contract loading, administration, and compliance oversight.
- Strong communication, critical thinking, problem-resolution and interpersonal skills.
Preferred Qualifications
- Proficiency in Microsoft Office Suite (e.g., Excel, Word, PowerPoint, Outlook).
Education
- Bachelor's degree preferred, or a combination of professional work experience and education.
Pay Range
The typical pay range for this role is:
$82,940.00 - $182,549.00
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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Skills Required
- 7+ years of progressive experience leading complex initiatives and delivering measurable business outcomes
- 5+ years of healthcare industry experience, including contracting options, financial and contracting arrangements, competitor strategies, and regulatory requirements
- Ability to manage multiple priorities while executing against timelines, budgets, and performance objectives
- Experience identifying issues, analyzing data, and making decisions to drive operational and financial results
- Experience influencing and partnering with cross-functional stakeholders to achieve shared business goals
- Ability to influence across a highly matrixed organization and partner with market stakeholders
- Knowledge of provider contracting systems and contract implementation processes, including contract loading, administration, and compliance oversight
- Strong communication, critical thinking, problem-resolution, and interpersonal skills
- Proficiency in Microsoft Office Suite, including Excel, Word, PowerPoint, and Outlook
- Bachelor's degree or equivalent combination of professional work experience and education
CVS Health Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about CVS Health and has not been reviewed or approved by CVS Health.
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Healthcare Strength — Health coverage includes medical, dental, and vision with HSA-eligible options, free preventive care, virtual care, and access to MinuteClinic services. Mental-health resources such as counseling support are emphasized, and coverage is often considered solid for full-time colleagues.
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Retirement Support — A dollar-for-dollar 401(k) match up to 5% after one year and an Employee Stock Purchase Plan are consistently highlighted in Total Rewards materials. Feedback suggests retirement programs are a meaningful strength within the overall package.
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Wellbeing & Lifestyle Benefits — Wellbeing offerings include up to 20 no-cost counseling sessions per issue, backup care, tuition assistance, and substantial in-store discounts, alongside broader wellness tools. These everyday perks expand value beyond base pay and can be especially meaningful for full-time schedules.
CVS Health Insights
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.
