New Albany, OH · On-site
$60K - $159K/yr
By working closely with other areas of the company such as Network, Provider Data Services, Next ... Required Qualifications - Experience with SCM (Strategic Contract Manager) and/or EPDB (Enterprise ...
New
New Albany, OH · On-site
$60K - $159K/yr
By working closely with other areas of the company such as Network, Provider Data Services, Next ... Required Qualifications - Experience with SCM (Strategic Contract Manager) and/or EPDB (Enterprise ...
New
New Albany, OH · On-site
$60 - $159/hr
As part of the Network Contract Validation team, you will be responsible for reviewing, auditing ... Project Management * Basic understanding of Provider Contracting * Experience with EXCEL and ...
Posted today
New Albany, OH · On-site
$60 - $159/hr
As part of the Network Contract Validation team, you will be responsible for reviewing, auditing ... Project Management * Basic understanding of Provider Contracting * Experience with EXCEL and ...
Posted today
Provide leadership and team management to guide and the Infrastructure / Networking team. Including mentoring, performance management, and fostering a collaborative work environment. * Collaborate ...
Provide leadership and team management to guide and the Infrastructure / Networking team. Including mentoring, performance management, and fostering a collaborative work environment. * Collaborate ...
New Albany, OH · On-site
Provide after-hours support for all network infrastructure hardware and systems * Participate in managing all network security solutions * Perform network and security audits of all company systems
New Albany, OH · On-site
Provide after-hours support for all network infrastructure hardware and systems * Participate in managing all network security solutions * Perform network and security audits of all company systems
New Albany, OH · On-site
Provide after-hours support for all network infrastructure hardware and systems * Participate in managing all network security solutions * Perform network and security audits of all company systems
New Albany, OH · On-site
Provide after-hours support for all network infrastructure hardware and systems * Participate in managing all network security solutions * Perform network and security audits of all company systems
$90K - $110K/yr
Provide after-hours support for all network infrastructure hardware and systems * Participate in managing all network security solutions * Perform network and security audits of all company systems
Quick apply
$90K - $110K/yr
Provide after-hours support for all network infrastructure hardware and systems * Participate in managing all network security solutions * Perform network and security audits of all company systems
New Albany, OH · On-site
Provide after-hours support for all network infrastructure hardware and systems * Participate in managing all network security solutions * Perform network and security audits of all company systems
New Albany, OH · On-site
Provide after-hours support for all network infrastructure hardware and systems * Participate in managing all network security solutions * Perform network and security audits of all company systems
Hilliard, OH · On-site
... 30%) 2) Providing hardware and software technical support to all users and providing 2nd tier ... Managing 3rd party professional services vendors. (10%) 5) Manage technological projects as ...
Hilliard, OH · On-site
... 30%) 2) Providing hardware and software technical support to all users and providing 2nd tier ... Managing 3rd party professional services vendors. (10%) 5) Manage technological projects as ...
Hilliard, OH · On-site
... 30%) 2) Providing hardware and software technical support to all users and providing 2nd tier ... Managing 3rd party professional services vendors. (10%) 5) Manage technological projects as ...
Hilliard, OH · On-site
... 30%) 2) Providing hardware and software technical support to all users and providing 2nd tier ... Managing 3rd party professional services vendors. (10%) 5) Manage technological projects as ...
If you thrive in fast-paced service provider (ISP) environments, enjoy solving complex network ... change management, incident response, documentation, customer communications, and on call ...
Quick apply
If you thrive in fast-paced service provider (ISP) environments, enjoy solving complex network ... change management, incident response, documentation, customer communications, and on call ...
If you thrive in fast-paced service provider (ISP) environments, enjoy solving complex network ... Participate in change management, incident response, documentation, customer communications, and ...
If you thrive in fast-paced service provider (ISP) environments, enjoy solving complex network ... Participate in change management, incident response, documentation, customer communications, and ...
If you thrive in fast-paced service provider (ISP) environments, enjoy solving complex network ... Participate in change management, incident response, documentation, customer communications, and ...
If you thrive in fast-paced service provider (ISP) environments, enjoy solving complex network ... Participate in change management, incident response, documentation, customer communications, and ...
... network management for the Key Family. Essential Duties and Responsibilities: * Relationship ... Provide superior, professional, ongoing, consistent communication and service with designated ...
... network management for the Key Family. Essential Duties and Responsibilities: * Relationship ... Provide superior, professional, ongoing, consistent communication and service with designated ...
... functions of network management for the Key Family. Essential Duties and Responsibilities:Relationship oversight of all current and potential networks.Serves as a liaison between network ...
Quick apply
... functions of network management for the Key Family. Essential Duties and Responsibilities:Relationship oversight of all current and potential networks.Serves as a liaison between network ...
... network management for the Key Family. Essential Duties and Responsibilities: * Relationship ... Provide superior, professional, ongoing, consistent communication and service with designated ...
... network management for the Key Family. Essential Duties and Responsibilities: * Relationship ... Provide superior, professional, ongoing, consistent communication and service with designated ...
Columbus, OH · On-site
... provider network compliance requirements. * Experience leading cross-functional accreditation ... Experience supporting or managing Credentialing and Recredentialing (CR) activities * Proven ...
Columbus, OH · On-site
... provider network compliance requirements. * Experience leading cross-functional accreditation ... Experience supporting or managing Credentialing and Recredentialing (CR) activities * Proven ...
Westerville, OH · On-site
$18.75 - $25/hr
Brokerage & Carrier Management * Carrier Sourcing & Negotiation: Source capacity from our highly vetted provider network and negotiate competitive rates to maximize margin while ensuring service ...
Quick apply
Westerville, OH · On-site
$18.75 - $25/hr
Brokerage & Carrier Management * Carrier Sourcing & Negotiation: Source capacity from our highly vetted provider network and negotiate competitive rates to maximize margin while ensuring service ...
$80K - $95K/yr
... management processes by preparing implementation steps, executing approved changes, and providing ... network specifications, and enterprise policy. Preferred Qualifications: * Possess excellent ...
$80K - $95K/yr
... management processes by preparing implementation steps, executing approved changes, and providing ... network specifications, and enterprise policy. Preferred Qualifications: * Possess excellent ...
Columbus, OH · On-site
$80K - $95K/yr
... management processes by preparing implementation steps, executing approved changes, and providing ... network specifications, and enterprise policy. Preferred Qualifications: * Possess excellent ...
Columbus, OH · On-site
$80K - $95K/yr
... management processes by preparing implementation steps, executing approved changes, and providing ... network specifications, and enterprise policy. Preferred Qualifications: * Possess excellent ...
Columbus, OH · On-site
$18.75 - $25/hr
Brokerage & Carrier Management * Carrier Sourcing & Negotiation: Source capacity from our highly vetted provider network and negotiate competitive rates to maximize margin while ensuring service ...
Columbus, OH · On-site
$18.75 - $25/hr
Brokerage & Carrier Management * Carrier Sourcing & Negotiation: Source capacity from our highly vetted provider network and negotiate competitive rates to maximize margin while ensuring service ...
$22K - $34.8K
0% of jobs
$34.8K - $47.5K
0% of jobs
$47.5K - $60.3K
5% of jobs
$60.3K - $73.1K
11% of jobs
$83.3K is the 25th percentile. Wages below this are outliers.
$73.1K - $85.9K
12% of jobs
$85.9K - $98.6K
15% of jobs
The median wage is $106K / yr.
$98.6K - $111.4K
14% of jobs
$111.4K - $124.2K
17% of jobs
$126.4K is the 75th percentile. Wages above this are outliers.
$124.2K - $137K
14% of jobs
$137K - $149.7K
6% of jobs
$149.7K - $162.5K
7% of jobs
$22K
$106.6K
$162.5K
Cities with the most Provider Network Manager job openings:
States with the most job openings for Provider Network Manager jobs include:
The most popular types of Provider Network jobs are:
The top 10 employers for Provider Network Manager jobs are:
$60K - $159K/yr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 3 days ago
New
Review, audit, and coordinate the correction of HRP contract setup against contract intent.
Evaluate the pricing performance of claims to ensure accurate provider pricing configuration.
Work closely with various teams to ensure correct decisions are made when configuring contract and pricing features in HRP prior to contract implementation.
5.8
Based on 4,361 frontline employees who took The Breakroom Quiz
92nd of 113 rated pharmacies
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 ourselvesaccountable 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
Dynamic position within the new Network Contract Validation team, responsible for ensuring accurate payment of provider contracts through Health Rules Payor (HRP) a claims processing platform. As part of the Network Contract Validation team, you will be responsible for reviewing, auditing, and coordinating the correction (if necessary) of HRP contract setup against contract intent and evaluate the pricing performance of claims. Accurate provider pricing configuration is critical to claims adjudication, and ultimately, having satisfied consumers and providers. By working closely with other areas of the company such as Network, Provider Data Services, Next Gen Provider Contract/Pricing team, Business Intent Review (BIR), HRP Provider Demographics, HRP Claims, HRP Product, legal/compliance, medical policy, and/or segment leaders this position will be responsible for ensuring the correct decisions were made when configuring contract and pricing features in HRP prior to contract implementation. Additionally, this role may participate with workgroups for process improvement.
Required Qualifications
- Experience with SCM (Strategic Contract Manager) and/or EPDB (Enterprise Provider Database), and/or HRP (Health Rules Payor)
- Project Management
- Basic understanding of Provider Contracting
- Experience with EXCEL and working with large data files is critical.
Preferred Qualifications
- Claims processing experience is desired.
- Experience with Health Rules Payor is desired.
- Proven track record in meeting project milestones and negotiating for resources.
- Proven communication skills both written and verbal.
- Proven ability to affect change/interpersonal skills.
- Knowledge of Aetna's Commercial and Medicare products
- Strong organization skills & time management
- Able to independently resolve problems.
- Ability to handle multiple assignments accurately and efficiently
- Able to interpret data, translate it into meaningful information and draw conclusions
Education
-Bachelor's degree preferred/specialized training/relevant professional qualification
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$60,300.00 - $159,120.00This 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 offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.
Additional details about available benefits are provided during the application process and on Benefits Moments.
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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Health care and social assistance and retail
10,000+ Employees
Woonsocket, RI, US
