Bringing our heart to every moment of your health.
Network Relations Senior Analyst
Location
United States
Posted
60 days ago
Salary
$47.0K - $112K / year
Seniority
Senior
No structured requirement data.
Job Description
Network Relations Senior Analyst
CVS Health
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Sr Analyst will join a rental vendor and provider operations team within Network Strategy & Provider Experience and will develop, maintain, and enhance rental vendor and provider relationships including with strategic network vendors and partners including facilities and physicians which serve as contractual networks of care for our members. Serve as the subject matter expert in support of contracting initiatives and data audits to enhance vendor program performance and provider networks while meeting and exceeding accessibility, compliance, quality, and financial goals. Responsible for reviewing, building, and auditing complex contract and network data; may support recruitment efforts and collaborate on negotiations as needed. - Responsible for reviewing, building, loading, and auditing complex contracts, agreements, amendments and/or fee schedules in contract management systems. - Conducts research, analysis and/or audits to identify issues and propose solutions to protect data, contract integrity, and performance. - Manages and performs scheduled program operations reporting and reconciliation activities. - Provides technical expertise for questions related to contracting and related systems and information contained. - Partner across the organization to support network development, maintenance, refinement activities, regulatory filings, migration, and rate activities. - Coordinate program operations activities, lead rental vendor implementation and provider onboarding work stream activities - Coordinate receipt and processing of provider network data including demographics, reimbursement, contracts, and documentation; may support pre-and post-signature review of contracts and language modification. - Supports negotiations via handling of system set up within Aetna systems for Commercial programs and contracts. - Conduct service activities such as provider education, technology usage, or process/policy updates. - Coordinate data analysis to identify root causes, develop/contact recruitment targets in support of network management expansion initiatives or analyze market data for outreach mailings to desired expansion targets. Required Qualifications - 5+ years related provider service experience successfully resolving and responding to provider reimbursement inquiries. - Advanced user experience in provider data/network setup and maintenance and claims research in core systems (ACAS, PRMS, EPDB, SCM). - Demonstrated root cause analysis and problem resolution skills. - Strong meeting facilitation, organizational, and documentation skills. - Strong communication, critical thinking, and interpersonal skills. - Advanced Excel and Crystal reporting skills. Preferred Qualifications - Experience working w/ cross-functional teams and IT to resolve complex bi-directional data exchange issues including member/provider data rosters, and capitation rosters. - Experience working w/ approval committees such as HOPP/NVDOC/NPL to update internal/external reference tools. - Working knowledge of standard provider contracts, terms, and language. Education - Associate degree or equivalent combination of education and health care operations experience. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $112,200.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 04/30/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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Program Cost / Control Analyst, Lead
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• Assist in the day-to-day activities of the QA team • Ensure effective collaboration and productivity with operations • Assist in creating and developing effective QA process tracking tools and strategies • Create reports and analyze data for management's use • Maintain monthly reports of the management related to performance/manpower • Help out in other data-related tasks from the management




