Associate, Payer Contracting, Credentialing

CVS Health

. Own payer contracting and credentialing for newly acquired pharmacies .

Posted 10/7/2026full-timeUnited StatesJuniorMid-LevelWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in payer contracting, pharmacy credentialing, and managed care enrollment processes, with a strong focus on compliance and risk management. Proficient in building and maintaining operational playbooks and managing multiple projects with varying deadlines.

Highest-signal resume keywords

Payer ContractingPharmacy CredentialingNCPDP KnowledgeMedicaid EnrollmentProcess-Building

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Payer EnrollmentManaged Care ContractingPBM Network OperationsCMS EnrollmentDocumenting WorkCreating ChecklistsRevalidationsOwnership Change ReportingClaims ManagementCompliance Management

Soft Skills

Strong OrganizationClear Written Communication

Tools & Technologies

NotionLinearGoogle WorkspaceSpreadsheets

Industry Keywords

PBMMedicaidFWA TrainingCredential RenewalsChange-of-Ownership

About the role

Key responsibilities & impact

Own payer contracting and credentialing for newly acquired pharmacies
Run PBM change-of-ownership processes end to end, including NCPDP ownership updates, provider applications, ownership and control disclosures, and supporting document packets
Enroll or re-enroll locations with state Medicaid programs and Medicare Part B, including revalidations and ownership change reporting
Build and maintain a post-close contracting playbook with checklists, timelines, document templates, and state-by-state Medicaid requirements
Track workstreams, statuses, blockers, and deadlines in Linear, Notion, and Google Drive
Lead Elevate concierge onboarding for each location
Work with Finance to reconcile remittances, ERAs, and payments in one place
Identify and escalate risks such as claims under seller credentials, lapsed enrollments, and recoupment exposure
Maintain compliance obligations including annual attestations, FWA training, credential renewals, and responses to PBM and Medicaid audits or document requests
Collaborate with Operations, Finance, pharmacists-in-charge, and outside partners
Ensure current locations have documented contracting statuses and that new acquisitions progress on predictable timelines

Requirements

What you’ll need

2–4 years of experience in pharmacy credentialing, payer enrollment, managed care contracting, or PBM network operations
Experience with pharmacy CHOW or acquisitions is a strong plus
Working knowledge of NCPDP, PBM provider portals, state Medicaid enrollment, and CMS enrollment (PECOS, 855 forms)
Very strong organization and ability to manage dozens of parallel applications with different deadlines
Process-building ability, including documenting work and creating reusable checklists
Clear written communication with PBMs, state agencies, sellers, and internal teams
Comfort with Notion, Linear, Google Workspace, and spreadsheets
Interest in using AI tools to automate form-heavy work is a plus
Must answer whether employment visa sponsorship will be required to work in the United States

Benefits

Comp & perks

No specific benefits or compensation extras stated