Behavioral Health Provider Relations Lead

CVS Health; Louisiana; On-site; USD 54,000 - 119,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement plan

Wellness programs

Job summary

CVS Health is hiring for an experienced healthcare professional to support Medicaid providers and provider networks. This individual contributor role focuses on credentialing, contract interpretation, and cross-functional collaboration across departments to optimize provider engagement.

The successful candidate will have significant healthcare experience, Medicaid insights, and strong communication skills, with substantial travel within Louisiana.

Qualifications

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

Responsibilities

• Optimizes interactions with assigned providers and internal partners to build productive relationships.
• Monitors service capabilities and collaborates cross-functionally to meet needs and resolve escalated issues.
• Supports operational activities such as database management and contract coordination.
• Performs credentialing support activities as needed.
• Educates Medicaid providers to ensure compliance with contracts and plan design.
• Meets with key providers regularly to ensure service levels meet expectations.
• Manages meeting agendas, validates materials, and facilitates external provider meetings.
• Collaborates cross-functionally on provider system implementations to manage cost drivers.
• May provide guidance and training to less experienced team members.
• Exhibits strong verbal/written communication, interpersonal, and problem-resolution skills.
• Collaborates on provider-facing communications, workflows, and HUB support.
• Other duties as assigned.

Skills

Verbal communication

Written communication

Problem solving

Interpersonal skills

Microsoft Office

Education

Bachelor's degree preferred

Tools

Microsoft Office Suite

Job description

CVS Health is hiring for an experienced healthcare professional to support Medicaid providers and provider networks. This individual contributor role focuses on credentialing, contract interpretation, and cross-functional collaboration across departments to optimize provider engagement.

The successful candidate will have significant healthcare experience, Medicaid insights, and strong communication skills, with substantial travel within Louisiana.