Network Management – Contracting Business Manager

Job not on LinkedIn

🔥 13 hours ago

🐎 Kentucky – Remote

🐎 Kentucky – Remote

💵 $54.3k - $119.3k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

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CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Provide analytical, reporting, and operational support across Network Management, Provider Engagement, and Contracting functions • Support preparation, analysis, tracking, and submission of state, regulatory, and accreditation-related network reports • Monitor reporting requirements, findings, approvals, corrective actions, and committee activities • Maintain documentation and supporting evidence for regulatory and audit readiness • Coordinate and monitor network-related projects and enterprise initiatives • Analyze network adequacy and accessibility across provider types • Evaluate geographic access, availability, utilization, compliance regulations, out-of-network activity, and network performance indicators • Identify network gaps, trends, risks, and improvement opportunities • Support development and monitoring of action plans • Identify workflow gaps and improve network and contracting operations • Recommend and measure process-improvement initiatives

🎯 Requirements

• 5 years of experience as a Business Analyst, Data Analyst, or Data-focused Product Owner • Experience with data governance and quality initiatives • Ability to navigate complex systems, applications, and data structures • Ability to troubleshoot technical issues, identify root causes, and drive timely resolution • Ability to prioritize competing work based on business and client needs • Must reside in Kentucky • Travel may be required based on business needs • Strong proficiency in Microsoft Office Suite, including Excel, Word, and PowerPoint • 3 to 5 years of healthcare experience, including claims data formats, risk adjustment methodologies, and provider network management (preferred) • Prior project management experience (preferred) • Ability to trace data from generation and ingestion to systems and reporting (preferred) • SQL proficiency, including writing queries for investigation, root cause analysis, and reporting logic (preferred) • Bachelor's degree, or equivalent combination of education and professional experience

🏖️ Benefits

• 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 eligibility

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