Behavioral Health Provider Relations Lead

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

Benefits offered by this job

Comprehensive benefits

Bonus potential

Job summary

CVS Health Corporation in Louisiana is seeking an experienced provider relations professional to manage high-profile Medicaid behavioral health providers. You will oversee contract language, service levels, and education needs, while coordinating with internal teams to address claims, payments and policy interpretation.

The role emphasizes cross-functional collaboration, credentialing support, and regular provider engagement to optimize performance in a complex regulatory environment.

Qualifications

• 5+ years' work experience in healthcare.
• 3 years' experience in Medicaid Managed Care servicing providers.
• 2 years' experience with behavioral health providers and contracts.
• Working knowledge of codes, products and terminology.
• Willingness to travel up to 50-80% within territory.

Responsibilities

• Act as primary resource for Behavioral Health providers to address Medicaid policies and contract issues.
• Maintain productive relationships with providers and internal partners.
• Support operational activities including data management and contract coordination.
• Perform credentialing support as needed.
• Educate providers on contract policies, plan design and processes.
• Meet with providers to ensure service levels meet expectations.
• Lead or support provider meetings and agenda development.
• Collaborate with cross-functional teams on large provider system implementations and cost initiatives.
• Provide guidance and training to junior team members.
• Communicate clearly with providers and internal stakeholders.

Skills

Microsoft Office Suite compatibility

Verbal and written communication

Interpersonal skills

Education

Bachelor's degree preferred

Tools

Microsoft Office Suite

Healthcare data concepts

Job description

CVS Health Corporation in Louisiana is seeking an experienced provider relations professional to manage high-profile Medicaid behavioral health providers. You will oversee contract language, service levels, and education needs, while coordinating with internal teams to address claims, payments and policy interpretation.

The role emphasizes cross-functional collaboration, credentialing support, and regular provider engagement to optimize performance in a complex regulatory environment.