CVS Health · 4 weeks ago
Senior Provider Network Contracting Manager - Medicaid
Frankfort, KY
Full-time
Onsite
Mid, Senior Level
$68K/yr - $149K/yr
3+ years expCVS Health is the nation’s leading health solutions company, dedicated to transforming health care. The Senior Provider Network Contracting Manager will review and negotiate complex Medicaid contracts, ensuring compliance and enhancing provider networks while collaborating with internal teams to drive cost savings and resolve service issues.
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Responsibilities
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
Qualification
Required
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
Working knowledge of QuickBase, QNEXT, PRMS and KIT systems preferred
Bachelor's degree preferred or a combination of professional work experience and education
Benefits
Affordable medical plan options
401(k) plan (including matching company contributions)
Employee stock purchase plan
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access
Company
CVS Health
CVS Health is a health solutions company that provides an integrated healthcare services to its members.
10001+ employees
Funding
Current Stage
Public CompanyTotal Funding
$4BKey Investors
Michigan Economic Development CorporationStarboard Value
2025-08-15Post Ipo Debt· $4B
2025-07-17Grant· $1.5M
2019-11-25Post Ipo Equity
Leadership Team
David Joyner
President and Chief Executive Officer, CVS Health
Chandra McMahon
SVP & CISO
Recent News
Maryland Daily Record
2026-01-19
bloomberglaw.com
2026-01-16
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