Job Description

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

    40

    Time Type

    Full time

    Pay Range

    The typical pay range for this role is:

    $54,300.00 - $145,860.00

    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. 
     

    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 

    We anticipate the application window for this opening will close on: 03/31/2026

    Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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