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
Acts as the primary resource for assigned profile of larger and more complex providers (i.e. market/regional/national, large group or hospital systems) to establish, oversee, and maintain provider risk management and positive relationships and supports high value initiative activities. Drives the implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets. May have limited contract negotiation responsibilities for assigned providers.
Key Responsibilities:
Optimizes interactions with assigned providers and internal business partners to establish and maintain productive, professional relationships and partners on the development of business strategy and programs to support the operational plans.
Collaborates cross-functionally to ensure resolution of escalated issues or projects for assigned provider systems and monitors performance and adherence to scorecards and payout schedules based on established quality, growth and clinical measures.
Educates internal and external parties as needed to ensure compliance with contract policies and parameters, plan design, compensation process, technology, performance measurement techniques, policies, and procedures.
Meets with key providers periodically to ensure service levels are meeting expectations.
Manages the development of agenda, validates materials, and facilitates external provider meetings.
May collaborate cross functionally on the implementation of large provider systems, to manage cost drivers, data reports and execute specific cost
initiatives to support business objectives and to identify trends and enlist assistance in problem resolution.
May have limited contract negotiation responsibilities for assigned providers.
May provide guidance and training to less experienced team members.
Required Qualifications
A minimum of 5 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.
A minimum of 3 years' experience with business segment specific policy, benefits, plan design and language.
Candidates must reside in Pennsylvania, Southern New Jersey, or the Delaware.
Preferred 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.
Working knowledge of business segment specific codes, products, and terminology.
Education
Bachelor’s Degree preferred or equivalent combination of education and experience.
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$60,300.00 - $145,860.00This 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 our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
For more information, visit https://jobs.cvshealth.com/us/en/benefits
We anticipate the application window for this opening will close on: 03/07/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.