Remote Network Relations Manager - Florida Health Network

CVS Health Corporation; Jacksonville (FL); Hybrid; USD 60,000 - 133,000; Full time

Job summary

CVS Health Corporation in Florida seeks a Network Relations Manager to drive the Value-Based Contracting strategy for the Rest of FL Market. You will develop and manage provider relationships to improve health outcomes, cost efficiency, and overall VBC initiatives.

Based in the Jacksonville or Orlando area with remote options, you will analyze provider performance, negotiate contracts, and partner with finance, operations, and clinical teams to strengthen the network and achieve strategic growth.

Qualifications

• Minimum 7 years of experience in healthcare quality, risk adjustment, or compliance within a Medicare Advantage setting.
• Minimum 5 years of experience in provider relationship management, network management, or provider services.
• Strong understanding of CMS regulations, HEDIS, STAR ratings, and provider engagement strategies.
• Must reside within the Florida market, with a preference for Jacksonville or Orlando areas.
• Bachelor's degree preferred or equivalent experience.

Responsibilities

• Establishes relationships with network providers and fosters open communication.
• Analyzes provider performance and conducts audits for contractual compliance.
• Resolves escalated provider issues with a proactive, customer-centric approach.
• Collaborates with network contracting teams to negotiate terms with providers.
• Develops plans to expand and enhance the network with business development teams.
• Monitors provider demographics and network adequacy metrics.
• Collaborates with finance, operations, and customer service for coordination.
• Conducts regular meetings and reviews with providers to discuss performance and improvements.
• Keeps updated on industry trends and regulatory changes that may impact provider relationships.

Skills

Provider relationship management

CMS regulations

Healthcare quality / risk adjustment

Data analysis

Contract negotiations

Education

Bachelor's degree

Job description

CVS Health Corporation in Florida seeks a Network Relations Manager to drive the Value-Based Contracting strategy for the Rest of FL Market. You will develop and manage provider relationships to improve health outcomes, cost efficiency, and overall VBC initiatives.

Based in the Jacksonville or Orlando area with remote options, you will analyze provider performance, negotiate contracts, and partner with finance, operations, and clinical teams to strengthen the network and achieve strategic growth.