Behavioral Health Medicaid Provider Relations Manager

MePA; Pineville (LA); Hybrid; USD 72,000 - 119,000; Full time

Benefits offered by this job

Bonus eligibility

Comprehensive benefits package

Paid time off

Retirement options

Job summary

CVS Health is hiring a Provider Relations professional in Louisiana to support high-profile behavioral health providers and groups. You will handle complex Medicaid policy questions, contract terms, and provider education, while coordinating with cross-functional teams to resolve issues related to claims and provider data.

The role requires 5+ years in healthcare, Medicaid experience, and 2+ years in behavioral health contracts. Travel up to 80% and a bachelor’s degree are typical prerequisites.

Qualifications

• Minimum of 5 years' work experience in healthcare.
• Minimum of 3 years' experience in Medicaid Managed Care servicing providers.
• Minimum of 2 years' experience with providers and contracts in behavioral health.
• Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint).
• Travel within territory up to 50-80%.
• Residence in Louisiana (St. Landry, Evangeline, Acadia, Lafayette, St. Martin, Iberia, Vermillion, Beauregard, Allen, Calcasieu, Jefferson Davis, Cameron, Avoyelles, Rapides, Vernon, Grant, Winn, LaSalle, Catahoula, Concordia).

Responsibilities

• Optimizes interactions with assigned providers and internal partners.
• Monitors service capabilities and resolves issues like claims payment or contract interpretation.
• Supports operational activities including contract coordination.
• Performs credentialing support as needed.
• Educates Medicaid providers on contract policies and procedures.
• Meets with providers to ensure service levels.
• Manages meeting agendas and materials for external provider meetings.
• Collaborates on large provider system implementations to manage cost drivers.
• May mentor less experienced team members.
• Communicates effectively with providers and internal teams.

Skills

MS Office

Communication skills

Problem solving

Travel up to 80%

Education

Bachelor's degree preferred

Job description

CVS Health is hiring a Provider Relations professional in Louisiana to support high-profile behavioral health providers and groups. You will handle complex Medicaid policy questions, contract terms, and provider education, while coordinating with cross-functional teams to resolve issues related to claims and provider data.

The role requires 5+ years in healthcare, Medicaid experience, and 2+ years in behavioral health contracts. Travel up to 80% and a bachelor’s degree are typical prerequisites.