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    AE

    Aetna

    Healthcare

    Provider Contract Negotiation Manager

    Work At Home-Ohio, United StatesRemoteFull-time5+ yrs experience$60.3k – $132.6kPosted 1w ago
    All Aetna jobs

    Job description

    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

    This is an individual contributor role.

    This remote position constructs negotiation, execution, review, and analysis of contracts. Delivers dispute resolution and settlement negotiations with providers. Ensures contract performance aligns with accessibility, compliance, quality, financial, and cost goals.
    What you will do

    • Negotiate single case agreements for episodes of care on a pre-service basis.
    • Participation/engagement of looking at forecast changes within the Contract Negotiations industry, development of business impact assessments, and modification strategies with the aid of process improvement methodologies.
    • Determines recommendations to manage cost issues and support cost-saving initiatives and settlement activities.
    • Develop, maintain, and enhance working relationships with physicians/providers and local network and patient management teams in the markets within Aetna.
    • Coaches more junior colleagues in techniques, processes, and responsibilities.
    • Collaborates cross-functionally with internal teams to support and manage negotiations, ensuring alignment and successful outcomes.

    Required Qualifications

    • 5+ years of experience in provider contracting, claims management, or patient management.
    • 2+ years of experience in claims operations or a related claims management environment.
    • 1-2 years of experience working with ACAS and HRP claims platforms, products, and benefits, as well as patient management, provider relations, or claims management.

    Preferred Qualifications

    • Knowledge/experience with National Advantage Program within Aetna.
    • Working knowledge of Aetna systems and tools, including Smart Front End, ASD, HRP, MedCompass, and RUMBA applications (EPDB, EWMP, Rate Inquiry, and Contract Inquiry).

    Education

    • Bachelor's degree preferred or a combination of professional work experience and education.

    Anticipated Weekly Hours

    40

    Time Type

    Full time

    Pay Range

    The typical pay range for this role is:

    $60,300.00 - $132,600.00

    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: 11/17/2026

    Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

    Job details are sourced from the employer's original posting.

    Open job posting
    AE

    About the company

    Aetna

    Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. Excellent benefits package, including 401k, tuition, licensure and certification reimbursement. We promote healthy & wellness lifestyles and offer specialty programs here at Aetna. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives. Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

    View all Aetna jobs
    Industry
    Healthcare
    Open roles
    319

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