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Provider Network Contract Manager Jobs in Ohio (NOW HIRING)

Contract Manager

Cincinnati, OH ยท On-site +1

$85K - $114K/yr

Contract and budget negotiation experience; * 3+ years of management or oversight experience ... providing phase l-lV clinical development services to the biotechnology, pharmaceutical, and ...

Contract Manager

Cincinnati, OH ยท On-site

$85K - $114K/yr

Contract and budget negotiation experience; * 3+ years of management or oversight experience ... providing phase l-lV clinical development services to the biotechnology, pharmaceutical, and ...

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Provider Network Contract Manager information

What is the difference between Provider Network Contract Manager vs Provider Contract Specialist?

AspectProvider Network Contract ManagerProvider Contract Specialist
CredentialsTypically requires a bachelor's degree in healthcare administration, business, or related field; certifications like CPC or CPMSM are commonSimilar credentials, often with healthcare or business background; certifications may include CPC or related
Work EnvironmentWorks within healthcare organizations or insurance companies, managing network contracts and negotiationsWorks in healthcare or insurance settings, focusing on contract review, processing, and compliance
Employer & Industry UsageUsed by health plans, provider networks, and insurance companies to manage provider agreementsCommonly employed in healthcare organizations and insurance firms for contract administration

The Provider Network Contract Manager oversees the negotiation and management of provider agreements, focusing on network development. The Provider Contract Specialist handles contract processing and compliance. While both roles require similar credentials and work in related environments, the manager has a broader strategic focus, whereas the specialist concentrates on contract details and administration.

What are some typical challenges faced by a provider network contract manager when negotiating contracts with healthcare providers?

A Provider Network Contract Manager often encounters challenges such as aligning payer and provider expectations, managing rate negotiations, and ensuring contract compliance with regulatory requirements. Balancing the need for competitive reimbursement rates while maintaining strong provider relationships can be complex, especially in markets with limited provider options. Additionally, contract managers must frequently collaborate with legal, finance, and clinical teams to address operational impacts and resolve disputes, making strong communication and negotiation skills essential.

What are the key skills and qualifications needed to thrive as a provider network contract manager?

To thrive as a Provider Network Contract Manager, you need expertise in healthcare contract negotiation, provider relations, and a solid understanding of insurance regulations, generally supported by a bachelor's degree in business, healthcare administration, or a related field. Familiarity with contract management software, data analysis tools, and knowledge of healthcare reimbursement systems is typically required. Strong communication, problem-solving, and relationship-building skills set top performers apart in this role. These abilities are crucial for building effective networks, ensuring compliance, and achieving cost-effective, high-quality care partnerships.

What is a provider network contract manager?

A Provider Network Contract Manager is a professional responsible for negotiating, developing, and managing contracts with healthcare providers such as hospitals, physicians, and clinics on behalf of insurance companies or healthcare organizations. Their main goal is to ensure that a network of providers delivers quality care to members at cost-effective rates. They also monitor contract compliance, analyze provider performance, and address any issues that may arise between providers and the organization. This role requires strong negotiation, communication, and analytical skills.

What job categories do people searching Provider Network Contract Manager jobs in Ohio look for?

The top searched job categories for Provider Network Contract Manager jobs in Ohio are:

What cities in Ohio are hiring for Provider Network Contract Manager jobs?

Cities in Ohio with the most Provider Network Contract Manager job openings:

Infographic showing various Provider Network Contract Manager job openings in Ohio as of August 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution.

Lead Director - Medical Pharmacy Network

Hispanic Alliance for Career Enhancement

Wyoming, OH โ€ข On-site

$100 - $232/hr

Other

Medical, Dental, Vision, Retirement, PTO

Posted yesterday

New


Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Healthยฎ, 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

Drives network strategy and performance improvement for medical drug reimbursement across hospital, health system, and regional provider partners. Enables market teams with contracting guidance, analytics, and best practices to improve cost, quality, and access outcomes.

  • Develop Market Network contract relationships providing support for market agreements/negotiations with health systems, hospitals and regional provider groups.
  • Align broader medical pharmacy strategy with National Ancillary Network & Value-Based Care teams.
  • Designs strategic retail network initiatives and plans by analyzing market trends, assessing competitive advantages, and identifying opportunities to grow the network's effectiveness and efficiency.
  • Defines programs to ensure alignment and integration of the provider network strategy with overall business objectives, collaborating with operations, marketing, and finance.
  • Controls all systems that monitor the performance of the medical pharmacy / infusion provider network, subsequently analyzing key performance indicators and identifying specific areas for improvement.
  • Communicates with external stakeholders, including healthcare organizations and insurance providers, to establish partnerships and collaborative arrangements.
  • Aligns retail provider network strategies with legal and regulatory frameworks, ensuring critical compliance with all relevant health regulations and standards.
  • Advises senior management and stakeholders on provider network performance, patient expectations and outcomes, and key financial metrics and targets.
  • Designs key strategies for retail network performance and partners with market leaders to ensure business plan requirements and team objectives are consistently met.
Required Qualifications
  • At least 10 years of experience in health plan operations, network contracting, or provider-facing contracting environments.
  • At least 3 years of experience in a health plan setting, with exposure to payer operations and healthcare administration.
  • Demonstrated ability to translate complex contracting, financial, and operational information into concise, executive-level narratives that drive informed decisionโ€‘making, align stakeholders, and communicate business value effectively.
  • Proven ability to critically evaluate contract terms, reimbursement structures, and business proposals, confidently challenging unfavorable provisions and advocating for solutions that mitigate risk, protect organizational interests, and support longโ€‘term strategic objectives.
  • Demonstrated knowledge of medical pharmacy reimbursement and outpatient reimbursement models, including payer and provider considerations.
Preferred Qualifications
  • Experience with health system and hospital network contracts.
  • Contracting experience with infusion, medical pharmacy arrangements, and/or valueโ€‘based care.
Education
  • Bachelor's degree preferred or a combination of education and work experience.
Pay Range

The typical pay range for this role is:

$100,000.00 - $231,540.00

This pay range represents the base hourly rate or base annual fullโ€‘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. This position also includes an award target in the company's equity award program.

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 fullโ€‘time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellโ€‘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: 09/19/2026

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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