Medicaid Provider Relations Manager

CVS Health; Oregon; Hybrid; USD 60,000 - 133,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Retirement savings

Paid time off

Job summary

CVS Health in Dallas/Fort Worth is seeking an experienced Provider Relations professional to serve as the primary resource for Medicaid providers and groups, guiding them through contract language, plan design, service and claims issues while educating on policies and parameters. Requirements include at least 5 years in healthcare, a minimum of 3 years in Medicaid Managed Care, travel up to 50–80%, and residency in the Dallas/Fort Worth Metroplex.

A Bachelor's degree is preferred.

Qualifications

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

Responsibilities

• Acts as the primary resource for assigned providers and/or groups to address complex issues about Medicaid policies, plan design, contract language, service, claims or compensation, and provider education needs.
• Optimizes interactions with providers and internal partners to maintain productive relationships.
• Supports credentialing and contract coordination; educates providers on policies and parameters.
• Meets with key providers, manages agendas, and facilitates external provider meetings.
• Collaborates with cross-functional teams on large provider system implementations and cost initiatives.

Skills

Healthcare experience

Provider relations

Communication skills

Problem solving

Education

Bachelor's degree preferred

Job description

CVS Health in Dallas/Fort Worth is seeking an experienced Provider Relations professional to serve as the primary resource for Medicaid providers and groups, guiding them through contract language, plan design, service and claims issues while educating on policies and parameters. Requirements include at least 5 years in healthcare, a minimum of 3 years in Medicaid Managed Care, travel up to 50–80%, and residency in the Dallas/Fort Worth Metroplex.

A Bachelor's degree is preferred.