Behavioral Health Provider Relations Manager

CVS Health Corporation; Pineville (LA); Presencial; USD 54 000 - 119 000; Tempo integral

Resumo da oferta

CVS Health Corporation is seeking a dedicated individual contributor to manage relationships with high-profile Behavioral Health providers and groups. You will address complex Medicaid policy issues, plan design, contract language, and provider education needs.

Responsibilities include coordinating with cross-functional teams to resolve claims, contracts, and provider data, while supporting credentialing and provider education.

Qualificações

• Minimum of 5 years' work experience in healthcare.
• Minimum of 3 years' experience in Medicaid Managed Care environment servicing providers with exposure to benefits or contract interpretation.
• Minimum of 2 years' experience working with providers and contracts in the behavioral health sector.
• Proficiency in Microsoft Office Suite, including Excel, Word, and PowerPoint.

Responsabilidades

• Optimizes interactions with assigned providers and internal partners to establish productive relationships.
• Monitors service capabilities and collaborates cross-functionally to meet provider needs and resolve escalated issues (claims payment, contract interpretation, provider data).
• Supports operational activities including database management and contract coordination.
• Performs credentialing support activities as needed.
• Educates Medicaid providers to ensure compliance with contract policies and parameters.

Conhecimentos

Healthcare

Medicaid knowledge

Contract interpretation

Communication skills

Travel willingness

Formação académica

Bachelor's degree preferred

Ferramentas

Microsoft Office Suite

Excel

Word

PowerPoint

Descrição da oferta de emprego

CVS Health Corporation is seeking a dedicated individual contributor to manage relationships with high-profile Behavioral Health providers and groups. You will address complex Medicaid policy issues, plan design, contract language, and provider education needs.

Responsibilities include coordinating with cross-functional teams to resolve claims, contracts, and provider data, while supporting credentialing and provider education.