Strategic Behavioral Health Provider Relations Lead

MePA; Sulphur (LA); Híbrido; USD 54 000 - 119 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical insurance

Dental and Vision coverage

Paid time off

Retirement savings options

Wellness programs

Resumo da oferta

CVS Health is seeking an experienced Provider Relations Specialist to manage high-profile Behavioral Health providers and groups across Medicaid operations. You will respond to complex policy and contract questions, coordinate credentialing support, and educate providers to ensure contract compliance.

The role emphasizes cross-functional collaboration, proactive issue resolution, and regular provider meetings to maintain service levels.

Qualificações

• Minimum 5 years' work experience in healthcare.
• Minimum 3 years' experience in Medicaid Managed Care servicing providers with exposure to benefits/contract interpretation.
• Minimum 2 years' experience working with providers and contracts in behavioral health.
• Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint).
• Travel within the defined territory up to 50-80% of the time.

Responsabilidades

• Acts as the primary resource for assigned Behavioral Health providers and/or groups to establish, oversee and maintain relationships.
• Responds to complex issues related to Medicaid policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs.
• Establishes productive relationships with providers and internal partners; resolves escalated issues such as claims payment and contract interpretation.
• Performs credentialing support activities as needed and educates Medicaid providers to ensure compliance with contracts.
• Collaborates cross-functionally on provider enablement, strategy, and communications.

Conhecimentos

Relationship management

Communication

Problem solving

Cross-functional collaboration

Provider education

Formação académica

Bachelor's degree preferred

Ferramentas

Microsoft Office

Descrição da oferta de emprego

CVS Health is seeking an experienced Provider Relations Specialist to manage high-profile Behavioral Health providers and groups across Medicaid operations. You will respond to complex policy and contract questions, coordinate credentialing support, and educate providers to ensure contract compliance.

The role emphasizes cross-functional collaboration, proactive issue resolution, and regular provider meetings to maintain service levels.