Behavioral Health Medicaid Provider Relations Manager

MePA; Louisiana; Hybrid; USD 54,000 - 119,000; Full time

Benefits offered by this job

Comprehensive benefits

Bonus eligibility

Job summary

CVS Health is seeking an experienced Provider Relations Specialist to manage relationships with Medicaid Behavioral Health providers across designated Louisiana parishes. You will address complex issues on contracts, plan design, and payment, while supporting credentialing and provider education.

The role requires 5+ years in healthcare, Medicaid Managed Care experience, and 2+ years in behavioral health contracts, with strong MS Office skills and significant travel. Bachelor's degree preferred.

Qualifications

• 5+ years' work experience in healthcare.
• 3+ years' experience in Medicaid Managed Care environment servicing providers with exposure to benefits/contract interpretation.
• 2+ years' experience working with providers and contracts in behavioral health.
• Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint).
• Travel within the defined territory up to 50-80% of the time.
• Must reside in Louisiana and within specified parishes.

Responsibilities

• Optimizes interactions with assigned providers and internal business partners to build productive relationships.
• Monitors service capabilities and collaborates cross-functionally to meet provider needs and resolve issues (claims payment, contract interpretation, provider data).
• Supports operational activities such as database management and contract coordination.
• Performs credentialing support activities as needed.
• Educates Medicaid providers to ensure contract compliance and policy adherence.
• Meets with key providers regularly to ensure service levels meet expectations.
• Leads agenda development, materials validation, and external provider meetings.
• Collaborates with cross-functional teams on provider system implementations and cost initiatives.

Skills

Healthcare experience

Medicaid knowledge

Contract interpretation

Relationship management

Communication skills

Travel readiness

Education

Bachelor's degree preferred

Tools

Microsoft Excel

Microsoft Word

Microsoft PowerPoint

Job description

CVS Health is seeking an experienced Provider Relations Specialist to manage relationships with Medicaid Behavioral Health providers across designated Louisiana parishes. You will address complex issues on contracts, plan design, and payment, while supporting credentialing and provider education.

The role requires 5+ years in healthcare, Medicaid Managed Care experience, and 2+ years in behavioral health contracts, with strong MS Office skills and significant travel. Bachelor's degree preferred.