Behavioral Health Provider Partnerships Manager

CVS Health Corporation; Baton Rouge (LA); On-site; USD 54,000 - 119,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Wellness programs

Job summary

CVS Health Corporation in Louisiana seeks an experienced healthcare professional for an individual contributor role focused on provider relations and Medicaid coordination, offering a clear path to impact within a nationwide health system.

You will optimize interactions with providers and internal partners, monitor service capabilities, support credentialing and contract coordination, educate Medicaid providers about policies and plan design, and lead or facilitate external provider meetings,

Qualifications

• Minimum 5 years' work experience in healthcare.
• Minimum of 3 years' experience in Medicaid Managed Care environment servicing providers with exposure to benefits and/or contract interpretation.
• Minimum of 2 years’ experience working with providers and contracts in the behavioral health sector.
• Working knowledge of business segment specific codes, products, and terminology.
• Proficiency in Microsoft Office Suite, including Excel, Word, and PowerPoint.
• Travel within the defined territory up to 50-80% of the time.
• Candidates must reside in the state of Louisiana and within one of the specified parishes.

Responsibilities

• Optimizes interactions with assigned providers and internal business partners to establish and maintain productive, professional relationships.
• Monitors service capabilities and collaborate cross- functionally to ensure that the needs of constituents are met and that escalated issues related to claims payment, contract interpretation or parameters, and accuracy of provider contract or demographic information are resolved.
• Supports or assists with operational activities that may include, but are not limited to, database management, and contract coordination.
• Performs credentialing support activities as needed.
• Educates Medicaid providers as needed to ensure compliance with contract policies and parameters, plan design, compensation process, technology, policies, and procedures.
• Meets with key Providers at regular intervals to ensure service levels meet expectations.
• Manages the development of agenda, validates materials, and facilitates external provider meetings.
• Collaborate cross-functionally with the implementation of large provider systems, to manage cost drivers and execute specific cost initiatives to support business objectives and to identify trends and enlist assistance in problem resolution.
• May provide guidance and training to less experienced team members.
• Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills.
• Collaborate with Provider Enablement & Strategy on Provider-facing communications, desktops, workflows, external training, reporting needs, and HUB support.
• Other duties as assigned.

Skills

Communication

Interpersonal skills

Problem solving

Critical thinking

Education

Bachelor's degree

Tools

Excel

Word

PowerPoint

Job description

CVS Health Corporation in Louisiana seeks an experienced healthcare professional for an individual contributor role focused on provider relations and Medicaid coordination, offering a clear path to impact within a nationwide health system.

You will optimize interactions with providers and internal partners, monitor service capabilities, support credentialing and contract coordination, educate Medicaid providers about policies and plan design, and lead or facilitate external provider meetings,