Network Management – Contracting Business Manager

Job not on LinkedIn

🔥 29 minutes ago

🐎 Kentucky – Remote

🐎 Kentucky – Remote

💵 $54.3k - $119.3k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 Description

• Provide analytical, reporting, and operational support across Network Management, Provider Engagement, and Contracting • Support regulatory and accreditation network reporting preparation, analysis, tracking, and submission • 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 primary care, specialty, behavioral health, and other 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 from network analyses • Identify workflow gaps and recurring issues in network and contracting operations • Recommend and support process-improvement solutions that improve efficiency, accountability, data accuracy, reporting, and provider experience

🎯 Requirements

• 5 years of experience as a Business Analyst, Data Analyst, or Data-focused Product Owner • Exposure to 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 • Candidates must reside in the state of Kentucky • Travel may be required based on business needs • Strong proficiency in Microsoft Office Suite, including Excel, Word, and PowerPoint • Preferred: 3 to 5 years of healthcare experience, including claims data formats, risk adjustment methodologies, and provider network management • Preferred: Project management experience leading cross-functional initiatives, managing timelines and deliverables, coordinating stakeholders, and driving projects to completion • Preferred: Ability to solve complex technical problems by tracing data from generation and ingestion to systems and reporting • Preferred: SQL proficiency, including writing queries for investigation, root cause analysis, and precise reporting logic • 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 in addition to base pay

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