Senior Analyst, Network Relations

CVS Health

Utah

On-site

USD 50,000 - 112,200

Full time

14 days+

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Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Other resources

Job summary

CVS Health is seeking a remote Regional Provider Relations Specialist in the West region. You will manage high-profile provider relationships, address complex claims, contracts, and education needs, and collaborate cross-functionally to sustain service levels and cost objectives.

The role emphasizes credentialing support, provider training, and cross-functional project participation, with a focus on accuracy and timely issue resolution.

Qualifications

3-5 years knowledge of codes, products, and terminology in the relevant business segment.
3-5 years of Microsoft Applications experience.
Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills.

Responsibilities

Act as the primary resource to establish and maintain provider relationships and address complex policy, contract, service or compensation issues.
Coordinate with internal partners to ensure provider needs are met and issues resolved.
Support credentialing, provider education, and contract coordination as needed.
Lead provider meetings, prepare agendas, and facilitate discussions to drive service levels.
Assist with large provider systems implementations and cost initiatives.

Skills

Verbal and written communication

Organizational skills

Multitasking

Time management

Education

Bachelor's Degree or equivalent

Tools

Microsoft Applications

Job description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

Acts as the primary resource for assigned, high profile providers or groups (i.e. local, individual providers, small groups/systems) to establish, oversee, and maintain positive relationships by assisting with or responding to complex issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs.

Optimizes interactions with assigned providers and internal business partners to establish and maintain productive, professional relationships. Monitors service capabilities and collaborates cross-functionally to ensure that the needs of constituents are met and that escalated issues related but not limited to, claims payment, contract interpretation or parameters, and accuracy of provider contract or demographic information are resolved. Supports or assists with operational activities that may include, but are not limited to, database management, and contract coordination. Performs credentialing support activities as needed. Educates providers as needed to ensure compliance with contract policies and parameters, plan design, compensation process, technology, policies, and procedures. Meets with key providers periodically to ensure service levels are meeting expectations. Manages the development of agenda, validates materials, and facilitates external provider meetings. May collaborate cross functionally on the implementation of large provider systems, to manage cost drivers and execute specific cost initiatives to support business objectives and to identify trends and enlist assistance in problem resolution. Conduct standard provider recruitment, contracting, or recontracting activities and assist with more complex contracting and discussions as needed by business segment. May provide guidance and training to less experienced team members.

REMOTE POSITION WITHIN WEST REGION

Required Qualifications

3- 5 years knowledge of business segment specific codes, products, and terminology.
3-5 years of Microsoft Applications experience
Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills.
The successful candidate must demonstrate exceptional organizational, multitasking, and time management skills, with the ability to effectively balance competing priorities in a fast-paced environment. This role requires the capacity to assess urgent needs, adapt to changing demands, and manage multiple assignments simultaneously while consistently meeting deadlines and maintaining a high level of accuracy and quality.

Preferred Qualifications

6+ years knowledge of business segment specific codes, products, and terminology.

Education

Bachelor's Degree or equivalent combination of education and experience.

Anticipated Weekly Hours

Time Type

Full time

Pay Range

The typical pay range for this role is:

$46,988.00 - $112,200.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.