CVS Health · 3 hours ago
Analyst, Payer Relations
Boston, MA
Full-time
Onsite
Entry Level
$21.10/hr - $44.99/hr
1+ years expCVS Health is dedicated to building a world of health around every individual, fostering a connected and compassionate health experience. The Payer Relations Analyst supports the Retail Health Payer Relations and Business Development team in managing payer contracts and ensuring operational alignment, while collaborating with various teams to enhance payer performance and resolve issues.
Health CareMedicalPharmaceuticalRetailSales
Responsibilities
Manage, maintain, and regularly update payer fee schedules and methodology in rate management system for assigned payer contracts
Monitor effective dates, rate changes, and contract modifications to ensure accurate and timely implementation
Support validation efforts to ensure payer reimbursement aligns with contracted terms
Identify changes to payer information, such as fee schedules, policies, ID Cards, plan/network/product changes and operational guidance via newsletters, bulletins, policy updates, and payer portals
Monitor communication channels and share updates with Payer Relations leads and internal stakeholders to ensure organizational compliance with payer expectations
Manage field-facing payer information to optimize accurate handling of patient registration, contract terms, and any payer nuances or requirements
Along with Payer Lead, partner with internal teams—including Contracting, Revenue Cycle Operations, Payer Analytics —to ensure accurate and timely contract alignment, payment accuracy, and operational execution
Work with Provider Field Leadership to support issue resolution tied to payer processes or contract interpretation
Act as the subject matter expert for the availability and effectiveness of payer communication channels (public website, secure portal, newsletters, provider relations, etc.)
Build and maintain strong working relationships with internal stakeholders and external payer counterparts
Assist in researching and resolving payer‑related operational issues identified by patient complaints, field inquiries, denied claims or payment variances. Collaborate as necessary with Payer Relations lead for consultation, interpretation, or escalation
Maintain documentation repositories for payer policies, requirements, and fee schedules
Qualification
Required
1–3 years of experience in healthcare operations, contracting, revenue cycle, payer relations, network management, or related fields
Strong analytical and organizational skills with high attention to detail
Ability to navigate and identify key information within payer policies, reimbursement structures, and operational guidance
Excellent communication and collaboration skills
Proficiency with Microsoft Excel, Microsoft Teams and reporting tools
Bachelor's degree or equivalent experience is required
Preferred
Experience working with payer contracts, reimbursement methodologies, and healthcare billing standards
Demonstrated skills navigating payer tools and relationships to efficiently obtain key payer information that informs reimbursement, coverage, and contractual compliance
Located close to a CVS hub location
Benefits
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.
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
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