Strategic Provider Network Relations Manager

CVS Health; Virginia; On-site; USD 54,000 - 146,000; Full time

Job summary

CVS Health is seeking an experienced Network Provider Relations professional to manage relationships with healthcare providers and facilities within our network. You will evaluate performance, resolve issues, and identify expansion opportunities while collaborating with internal teams to drive network growth.

The role requires 5+ years in provider relations, strong problem-solving skills, and the ability to travel up to 10%.

Qualifications

• 5+ years in healthcare provider relationship management with providers and health systems.
• Strong problem-solving and cross-functional collaboration skills.
• Proficiency with Microsoft Office including Excel and Outlook.
• Ability to travel up to 10%.

Responsibilities

• Establishes relationships with network providers, fostering open communication and collaboration to ensure a strong network partnership.
• Analyzes network provider performance and quality indicators, conducting regular assessments and audits to ensure compliance with contractual obligations and SLAs.
• Addresses and resolves escalated issues and concerns raised by network providers, demonstrating a proactive and customer-centric approach.
• Collaborates with network contracting teams to negotiate and establish contractual terms with providers.
• Develops tactical plans to expand and enhance the network, onboarding new providers in strategic areas.
• Monitors network data, including provider demographics and adequacy metrics, and recommends improvements.
• Coordinats with finance, operations, and customer service to align network activities and initiatives.
• Conducts regular meetings with providers to review performance metrics and identify improvement opportunities.
• Stays updated on industry trends and regulatory changes, communicating relevant information to stakeholders.

Skills

Provider relations

Data analysis

Travel

Cross-functional collaboration

Education

Bachelor's degree

Tools

Outlook

Job description

CVS Health is seeking an experienced Network Provider Relations professional to manage relationships with healthcare providers and facilities within our network. You will evaluate performance, resolve issues, and identify expansion opportunities while collaborating with internal teams to drive network growth.

The role requires 5+ years in provider relations, strong problem-solving skills, and the ability to travel up to 10%.