Medicaid Provider Relations Manager

CVS Health; Dallas (TX); On-site; USD 60,000 - 133,000; Full time

Job summary

CVS Health is seeking a Provider Relations Specialist to support Medicaid providers in the Dallas area. The role focuses on building and maintaining positive provider relationships, resolving complex issues related to contracts, claims, and provider education needs, and collaborating across teams to meet service goals.

Candidates should have healthcare experience, knowledge of Medicaid processes, CPT/ICD-10 familiarity, and a willingness to travel 50-80% within the defined territory; residency

Qualifications

• Minimum of 5 years' work experience in healthcare.
• Minimum of 3 years' experience in Medicaid Managed Care.
• Travel within the defined territory up to 50-80% of the time.
• Must reside in the Dallas/Fort Worth Metroplex.

Responsibilities

• Establish, oversee, and maintain positive relationships with Medicaid providers and groups.
• Respond to complex issues regarding contracts, service, claims or compensation, and provider education needs.
• Collaborate cross-functionally to ensure provider needs are met and issues are resolved.
• Monitor provider interactions and support credentialing or contract coordination as needed.

Skills

Healthcare experience

Medicaid terminology

Contract interpretation

Communication skills

Education

Bachelor's degree

Job description

CVS Health is seeking a Provider Relations Specialist to support Medicaid providers in the Dallas area. The role focuses on building and maintaining positive provider relationships, resolving complex issues related to contracts, claims, and provider education needs, and collaborating across teams to meet service goals.

Candidates should have healthcare experience, knowledge of Medicaid processes, CPT/ICD-10 familiarity, and a willingness to travel 50-80% within the defined territory; residency