Network Contract Specialist

Job Description
Responsible for loading, implementation, maintenance of standard provider contracts, schedules and agreements and files in support of business segment contracting initiatives.

Design, develop, contract, maintain and enhance relationships with facilities, physicians and ancillary providers which serve as contractual networks of care for members; foster growth of managed care products; and enhance profitability of Aetna.

Builds, loads and maintains standard contracts, agreements, amendments and/or fee schedules, tables in contract management systems. Ensure that signature and delegation activities are complete per required timeframes.
Partners with internal constituents and provides information to ensure contract compliance adherence to company policies and procedures including contracting guidelines, clinical and payment policy information, coding requirements, and other required policies/procedures. Sends, receives, processes and documents and triages provider contracts and agreements and ensures all paperwork is received, complete and accurate. Sends agreement to providers. Partners cross-functionally to ensure credentialing process is complete. Requests appropriate analyses (financial, legal, business language reviews) as appropriate. Maintains contract and agreement files and file management systems and spreadsheets and is single point of contact for questions related to same as well as special projects, internal audit, core, provider service organization and other functional areas for contract copies and information.

Pay Range
The typical pay range for this role is:
Minimum: 18.50
Maximum: 34.60

Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.

Required Qualifications
Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills with proven ability to influence and collaborate with providers and partners at all levels.

Contract interpretation skills

1-2 years' experience with business segment specific policy, benefits, plan design and language.

Preferred Qualifications
Working knowledge of internal contracting systems and processes

4+ years' experience in business segment specific environment servicing or managing non-standard relationships with providers with exposure to benefit plan design and/or contract interpretation.

3-5 years' experience with business segment specific policy, benefits, plan design and language.

Working knowledge of business segment specific codes, products, and terminology.

Education
Associate's degree or equivalent work experience.

Business Overview
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.