Provider Contract Negotiation Manager

CVS Health

. Negotiate single case agreements for episodes of care on a pre-service basis .

Posted 9/17/2026full-timeRemote • Alabama • United StatesMid-LevelSenior💰 $60,300 - $132,600 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in provider contracting and claims management, with a strong focus on negotiation, relationship building, and process improvement. Proficient in utilizing Aetna systems and tools to enhance contract performance and support cost-saving initiatives.

Highest-signal resume keywords

Provider ContractingClaims ManagementNegotiation SkillsAetna Systems KnowledgeProcess Improvement Methodologies

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Contract AnalysisBusiness Impact AssessmentCost ManagementDispute ResolutionSettlement Negotiations

Soft Skills

CoachingCollaborationRelationship Management

Tools & Technologies

ACASHRP Claims PlatformSmart Front EndASDMedCompassRUMBA ApplicationsEPDBEWMPRate InquiryContract Inquiry

Industry Keywords

Contract NegotiationsCost-Saving InitiativesPatient ManagementProvider RelationsNational Advantage Program

About the role

Key responsibilities & impact

Negotiate single case agreements for episodes of care on a pre-service basis
Analyze forecast changes within the Contract Negotiations industry
Develop business impact assessments and modification strategies using process improvement methodologies
Recommend approaches to manage cost issues and support cost-saving initiatives and settlement activities
Develop, maintain, and enhance relationships with physicians/providers and local network and patient management teams in Aetna markets
Coach more junior colleagues in techniques, processes, and responsibilities
Collaborate cross-functionally with internal teams to support and manage negotiations
Construct, execute, review, and analyze contracts
Deliver dispute resolution and settlement negotiations with providers
Ensure contract performance aligns with accessibility, compliance, quality, financial, and cost goals

Requirements

What you’ll need

5+ years of experience in provider contracting, claims management, or patient management
2+ years of experience in claims operations or a related claims management environment
1–2 years of experience working with ACAS and HRP claims platforms, products, and benefits, as well as patient management, provider relations, or claims management
Knowledge/experience with National Advantage Program within Aetna preferred
Working knowledge of Aetna systems and tools, including Smart Front End, ASD, HRP, MedCompass, and RUMBA applications (EPDB, EWMP, Rate Inquiry, and Contract Inquiry)
Bachelor's degree preferred or a combination of professional work experience and education
Ability to work remotely from one of the listed U.S. locations

Benefits

Comp & perks

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
CVS Health bonus, commission or short-term incentive program in addition to base pay