Senior Network Provider Manager, National Medicaid Ancillary Contracting

CVS Health

Senior Manager overseeing national Medicaid ancillary contracting efforts for CVS Health, focusing on provider relations, contract negotiations, and network expansion. Ensuring compliance with health plans and regulatory standards.

Posted 5/27/2026full-timeRemote • Idaho, Texas • 🇺🇸 United StatesSenior💰 $67,900 - $149,328 per yearWebsite

About the role

Key responsibilities & impact

Negotiates, executes, conducts high level review and analysis of dispute resolution and/or settlement negotiations of contracts with national providers
Recruit providers as needed to ensure attainment of network expansion goals
Support health plan with expansion initiatives or other contracting activities as needed
Initiates, coordinates and own the contracting activities to fulfillment
Responsible for auditing, building, and loading contracts, agreements, amendments and/or fee schedules in contract management systems per Aetna ’ s established policies
Conducts research, analysis and/or audits to identify issues and propose solutions
Manages contract performance and supports the development and implementation of value-based contract relationships
Collaborates cross-functionally to manage provider compensation and pricing development 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
Understanding of Value Based contracting and negotiations
Manage high level projects and recruitment initiatives with interdepartmental resources and/or cross functional stakeholders
Supports or assists with operational activities that may include, but are not limited to, database management and contract coordination
Organizing and transforming information into comprehensible structures
Using data to predict trends in the customer base and the consumer population as a whole
Performing statistical analysis of data
Using tools and techniques to visualize data in easy-to-understand formats, such as diagrams and graphs
Preparing reports and presenting these to leadership
Engage with providers and quickly move the providers though contracting processes

Requirements

What you’ll need

5+ years of network contracting/management experience
Ability to travel as needed (up to 25% travel)
5 years of proven knowledge of standard provider contracts, terms and language
5 years of solid negotiating and decision-making skills while executing national, regional, or market level strategies.
In-depth knowledge of the managed care industry and practices, as well as a strong understanding of competitor strategies, practices, and financial/contracting arrangements.
Knowledge of ancillary contracting, i.e. DME, Lab, Infusion, Home Health, Urgent Care and Vendor
Demonstrated high proficiency with personal computer, mouse, keyboard and all MS Office suite applications (e.g., Outlook, Word, Excel, etc.). - Knowledge of Medicaid programs.
Solid decision-making skills while executing national, regional, and market level strategies.
Ability to forge long-lasting relationship.
Possess critical thinking, problem resolution and interpersonal skills.
Ability to identify and capitalize on opportunities to support program delivery.
Strong communication skills (written, verbal and presentation).
Highly organized and self-driven.

Benefits

Comp & perks

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
CVS Health bonus
commission or short-term incentive program
equity award program

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

network contractingcontract managementnegotiationstatistical analysisdata visualizationcontract auditingprovider compensationvalue-based contractingdatabase managementcontract coordination

Soft Skills

decision-makingcritical thinkingproblem resolutioninterpersonal skillscommunication skillsorganizational skillsself-drivenrelationship buildingcollaborationpresentation skills