Behavioral Health Provider Relations Lead

MePA; New Iberia (LA); Hybride; USD 54 000 - 119 000; Plein temps

Avantages offerts par ce poste

Medical, dental, vision coverage

Paid time off

Retirement savings options

Wellness programs

Résumé du poste

CVS Health in Louisiana seeks an experienced Behavioral Health Provider Relations Specialist to manage Medicaid provider relationships, resolve contract and claims issues, and educate providers on contract policies.

The role is an individual contributor requiring strong communication, problem-solving, and collaboration with implementation teams to support cost initiatives and provider enablement.

Qualifications

• Minimum 5 years' work experience in healthcare.
• Minimum 3 years' experience in Medicaid Managed Care.
• Minimum 2 years' experience with providers and contracts in behavioral health.
• Working knowledge of codes, products, and terminology in the business segment.
• Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint).

Responsabilités

• Optimizes interactions with assigned providers and internal partners to maintain productive relationships.
• Monitors service capabilities and resolves issues related to claims, contracts, and provider data.
• Supports operational activities such as database management and contract coordination.
• Performs credentialing support activities as needed.
• Educates Medicaid providers to ensure compliance with contract policies and processes.
• Meets with key providers regularly to ensure service levels meet expectations.
• Manages meeting agendas and materials for external provider meetings.
• Collaborates cross-functionally to manage cost drivers and implement provider initiatives.
• May provide guidance and training to junior team members.
• Communicates effectively with providers and internal teams on workflows and reporting needs.

Connaissances

Healthcare experience

Medicaid knowledge

Provider relations

Contract interpretation

Microsoft Office

Travel willingness

Formation

Bachelor's degree

Outils

Microsoft Office

Description du poste

CVS Health in Louisiana seeks an experienced Behavioral Health Provider Relations Specialist to manage Medicaid provider relationships, resolve contract and claims issues, and educate providers on contract policies.

The role is an individual contributor requiring strong communication, problem-solving, and collaboration with implementation teams to support cost initiatives and provider enablement.