Strategic Behavioral Health Provider Relations Lead

CVS Health Corporation; Alexandria (LA); On-site; USD 72,000 - 119,000; Full time

Benefits offered by this job

Comprehensive benefits

Bonus eligibility

Paid time off

Job summary

CVS Health in Louisiana is seeking an experienced Provider Relations Specialist focused on Medicaid behavioral health. You will serve as the primary resource for assigned providers and groups, helping with contract language, plan design, service and claims issues, and provider education.

This role requires strong communication, cross-functional collaboration, and the ability to manage credentialing support and provider meetings.

Qualifications

• 5+ years in healthcare with Medicaid or managed care exposure.
• Experience servicing providers with benefit/contract interpretation.
• 2+ years in behavioral health contracts and provider relations.
• Proficiency in MS Office (Excel, Word, PowerPoint).

Responsibilities

• Act as primary resource for high-profile Medicaid behavioral health providers and groups.
• Resolve complex issues related to policies, contracts, service, and claims.
• Coordinate credentialing support and provider education needs.
• Educate providers to ensure contract policy and plan design compliance.
• Meet with providers to ensure service levels meet expectations.
• Collaborate cross-functionally for cost initiatives and trend identification.
• Lead or support provider meetings and materials preparation.

Skills

Healthcare experience

Medicaid knowledge

Behavioral health contracts

MS Office proficiency

Travel readiness

Education

Bachelor's degree preferred

Tools

Microsoft Office

Job description

CVS Health in Louisiana is seeking an experienced Provider Relations Specialist focused on Medicaid behavioral health. You will serve as the primary resource for assigned providers and groups, helping with contract language, plan design, service and claims issues, and provider education.

This role requires strong communication, cross-functional collaboration, and the ability to manage credentialing support and provider meetings.