[Hiring] Network Ancillary Provider Contracting Manager @CVS Health

Role Description

This is an individual contributor role. The Contract Manager will support the National Ancillary Contracting Team focused on National Laboratory contracting and other Network requests as assigned. This position is responsible for completing negotiations and re-negotiations, as well as executing provider contracts in alignment with company standards in order to maintain and enhance provider networks while meeting and exceeding accessibility, quality and financial goals.

• Provider contracting, including mastery of contracting methodologies, Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines, system loads, and provider configuration processes.
• Contracting with laboratories on a national scale and a strong understanding of competitor strategies, industry practices, and financial/contracting arrangements.
• Contract Negotiation to build positive provider relationships that support network growth and market competitiveness.
• Identify and leverage market opportunities to support program delivery.
• Analyze, identify, and report meaningful changes in network adequacy for applicable Commercial and Medicare products.
• Collaborate effectively across internal business units to achieve departmental and corporate goals.

Qualifications

• 5+ years of hands-on experience in healthcare provider contracting, including negotiating reimbursement terms, evaluating contracting options, and applying Preferred, Acceptable, Discouraged, Unacceptable (PADU) guidelines to ensure alignment with organizational strategy and regulatory requirements.
• 5+ years of experience in navigating complex provider contract structures, conducting rate and term analyses, and collaborating with cross-functional teams to finalize agreements.
• Experienced in system loads and provider configuration processes, ensuring contract terms are accurately built, validated, and implemented across internal platforms to support clean claim adjudication and operational efficiency.
• 2–3 years of experience and in-depth knowledge of the managed care industry, including a strong understanding of competitor strategies, industry practices, and financial/contracting arrangements. Specific experience in national laboratory contracting is required.

Requirements

• Strong written and verbal communication skills, with the ability to identify and capitalize on marketing opportunities to support effective program delivery.
• Strong attention to detail, with the ability to analyze, identify, and report significant changes in network adequacy across Commercial, High Performance Plan, and Medicare products.
• Demonstrated ability to collaborate effectively with multiple internal business areas to support organizational goals.
• Proficiency in Microsoft Excel and the full Microsoft Office Suite.

Education

• Bachelor’s degree preferred, or a combination of relevant professional experience and education.

Benefits

• Comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families.
• Medical, dental, and vision coverage.
• Paid time off.
• Retirement savings options.
• Wellness programs and other resources, based on eligibility.