Network Management & Contracting Business Manager (Kentucky)

Position Overview 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. This is an individual contributor role. The Network Management & Contracting Business Analyst provides analytical, reporting, and operational support across Network Management, Provider Engagement, and Contracting functions. This role serves as a centralized resource for network performance, regulatory and accreditation reporting, provider data, network adequacy, audit readiness, and key initiatives. The position analyzes complex information, identifies trends and risks, and delivers actionable insights to support informed decisions across network strategy, provider relationships, contracting, compliance, and operational priorities. Roles and Responsibilities Regulatory & Accreditation Reporting Support the preparation, analysis, tracking, and timely submission of required state, regulatory, and accreditation-related network reports. Monitor reporting requirements, findings, approvals, corrective actions, and related committee activities. Maintain documentation and supporting evidence to promote ongoing regulatory and audit readiness. Coordinate and monitor network-related projects and enterprise initiatives that impact providers, contracting, provider data, and network operations. Network Adequacy & Performance Analysis Analyze network adequacy and accessibility across primary care, specialty, behavioral health, and other provider types. Evaluate geographic access, availability, utilization, compliance regulations, out-of-network activity, and other network performance indicators. Identify potential network gaps, trends, risks, and opportunities for improvement. Support the development and monitoring of action plans resulting from network analyses. Process Improvement Identify recurring issues, workflow gaps, and opportunities to improve network and contracting operations. Recommend solutions that enhance efficiency, accountability, data accuracy, reporting, and provider experience. Support implementation and measurement of process-improvement initiatives. Required Qualifications 5 years of experience as a Business Analyst, Data Analyst, or Data-focused Product Owner, with exposure to data governance and quality initiatives. Demonstrated ability to quickly learn and navigate complex systems, applications, and data structures to effectively troubleshoot technical issues, identify root causes, and drive timely resolution. Demonstrated ability to prioritize competing priorities for work based on business and client needs, along with being able to describe the prioritization decision making to influence prioritization. Candidates must reside in the state of Kentucky. Travel may be required based on business needs, including attendance at meetings, training sessions, client engagements, and other company-related events. Strong proficiency in Microsoft Office Suite, including Excel, Word, and PowerPoint. Preferred Qualifications 3 to 5 years of experience in healthcare, including hands-on experience with core concepts and data (e.g., claims data formats, risk adjustment methodologies, and provider network management). Prior project management experience, including the ability to lead cross-functional initiatives, manage timelines and deliverables, coordinate stakeholders, and drive projects to successful completion. Demonstrated ability to solve complex technical problems through tracing data from generation and ingestion to systems and reporting. SQL proficiency with proven experience writing queries for investigation, root cause analysis, and defining precise reporting logic. Education Bachelor's degree, or equivalent combination of education and professional experience. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $54,300.00 - $119,340.00 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. 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: 01/04/2027 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area. #J-18808-Ljbffr 4004 Aetna Medicaid Administrators