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Illinois, United States
Remote only
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
The Contract Coordinator Analyst plays a critical role in supporting the Medicaid Network management team throughout the provider contracting lifecycle for Aetna Better Health of Illinois. This position works hand in hand with the Network Contracting Manager to ensure the accuracy and integrity of provider contract documentation for new providers joining the network, maintaining up-to-date provider information within internal systems, and supports compliance with regulatory and organizational requirements. See breakdown of specific job responsibilities below:
Perform thorough reviews of all incoming contractual documents to ensure completeness and accuracy; work with contracting staff to obtain missing or incomplete documents as needed
Work with national provider data service team to load newly contracted providers to the provider record database in a timely manner
Audit updated provider records to ensure the correct changes were made to the database; submit corrections as needed
Maintain the master repository of participating provider contracts, load newly executed provider agreements to the repository
Manage contracting team email box; appropriately respond and triage of both internal and external messages to the appropriate parties. Respond to emails within established turnaround times
Research and respond to inquiries from providers and internal staff regarding contractual matters such as a provider’s participating status in the Aetna Better Health of Illinois provider network
Send out provider welcome packets to newly contracted providers
Support internal contract auditing processes as requested
Compile, summarize and report on the Health Plan’s compliance with contract submission rules and exception requests, communicating on at minimum, a monthly basis
Assist with miscellaneous claims projects/audits and reviewing contracts and plan documents
Ensures compliance of health plan, corporate, state, and federal regulations
Escalate issues, as necessary, to management in a timely manner
Work with members of Network Development and internal department staff to identify process improvement opportunities
Perform other duties as assigned
Required Qualifications
2-5 years of professional work experience, 1 year in the healthcare industry
Experience working in TriZetto QNXT
Experience with medical terminology
Experience working with Microsoft Office Suite
Proven ability to manage multiple workflows, prioritize effectively, and meet deadlines
Strong written and verbal communication skills, with the ability to convey complex information clearly
Preferred Qualifications
Education
GED required, Bachelors preferred
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$46,988.00 - $112,200.00This 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.
