Behavioral Health Provider Relations Manager

CVS Health Corporation; United States; Remote; USD 54.000 - 119.000; Vollzeit

Zusammenfassung

CVS Health Corporation is recruiting an experienced provider relations professional in the United States to optimize interactions with Medicaid providers and internal partners, supporting credentialing and contract interpretation. This individual contributor role requires 5+ years in healthcare, up to 80% travel, and residency in Louisiana across specified parishes.

The position offers a full‑time schedule with a pay range of $54,300.00–$119,340.00, bonus eligibility, and a comprehensive

Qualifikationen

• 5+ years healthcare experience
• 3+ years in Medicaid Managed Care environment servicing providers with exposure to benefits/contract interpretation
• 2+ years experience working with providers and contracts in the behavioral health sector
• Travel within defined territory up to 50-80% of the time
• Residence in Louisiana within one of listed parishes (St. Landry, Evangeline, Acadia, Lafayette, St. Martin, Iberia, Vermillion, Beauregard, Allen, Calcasieu, Jefferson Davis, Cameron, Avoyelles, Rapides, Vernon, Grant, Winn, LaSalle, Catahoula, Concordia)

Aufgaben

• Optimizes interactions with providers and internal partners to establish productive relationships.
• Monitors service capabilities and collaborates cross-functionally to meet needs and resolve issues.
• 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, plan design, compensation process, technology, policies, and procedures.
• Meets with key providers to ensure service levels meet expectations.
• Manages the development of agendas, validates materials, and facilitates external provider meetings.
• Collaborates cross-functionally to manage cost drivers and identify trends for problem resolution.
• May provide guidance and training to less experienced team members.
• Collaborate with Provider Enablement & Strategy on provider communications, desktops, workflows, external training, reporting needs, and HUB support.
• Other duties as assigned.

Kenntnisse

Communication skills

Healthcare knowledge

Relationship management

Ausbildung

Bachelor’s degree preferred

Tools

Microsoft Office Suite

Jobbeschreibung

CVS Health Corporation is recruiting an experienced provider relations professional in the United States to optimize interactions with Medicaid providers and internal partners, supporting credentialing and contract interpretation. This individual contributor role requires 5+ years in healthcare, up to 80% travel, and residency in Louisiana across specified parishes.

The position offers a full‑time schedule with a pay range of $54,300.00–$119,340.00, bonus eligibility, and a comprehensive