Negotiation Manager - KY Medicaid

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.

Key responsibilities include:

• Reviews, analyzes, negotiates and executes Medicaid contracts.
• Leads reimbursement dispute resolution and settlement negotiations with provider groups for the Medicaid line of business.
• Completes all activities related to standard contract intake and implementation.
• Manages contract performance in support of network quality, availability, and financial goals and strategies.
• Recruits providers as needed to ensure attainment of network expansion and adequacy targets.
• Collaborates cross‑functionally to contribute to provider compensation and pricing development activities, submit contractual information, and review and analyze reports as part of negotiation and reimbursement modeling activities.
• Identifies and recommends actions to manage cost issues and supports cost‑saving initiatives and/or settlement activities.
• Provides network development, maintenance, and refinement activities and strategies as applicable.
• Provides contract expertise and support to other internal business partners/units related to contract setup accuracy, language interpretation, claims payment and other matters requiring network contracting expertise.
• Leads and/or participates in special projects.

• 3–5 years of experience with provider contract negotiations or provider relations.
• Proven working knowledge of the Medicaid service line, preferably the state of Kentucky program.
• Must reside in the state of Kentucky.

• Medicaid provider relations or claims payment expertise.
• Proven and proficient managed care network negotiating skills.
• Strong communication, critical thinking, problem resolution and interpersonal skills.
• Adept at execution and delivery (planning, delivering, and supporting) skills.
• Adept at business intelligence.
• Adept at collaboration and teamwork.
• Adept at growth mindset (agility and developing yourself and others).

Bachelor’s Degree or equivalent relevant work experience.

Anticipated Weekly

Hours:

40
Time Type:
Full time

Pay Range: $54,300.00 – $ (base hourly rate or base annual full‑time salary; actual offer depends on experience, education, geography and other factors).

This full‑time position is eligible for a comprehensive benefits package including 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: 07/31/2026.