Strategic Provider Relations Lead

CVS Health; Missouri; Hybrid; USD 47,000 - 112,000; Full time

Benefits offered by this job

Bonus program

Comprehensive benefits

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a provider relations professional to act as the primary resource for high profile providers or groups, on-site as needed, and to oversee contracts, plan design, and provider education to ensure policy compliance and service excellence. You will work with internal teams to resolve complex issues and maintain positive relationships.

The role requires 3–5 years of policy/benefit experience, a bachelor’s degree or equivalent, and strong communication skills, with a typical 40

Qualifications

• Working knowledge of policy, benefits and plan language.
• 3-5 years' experience with policy, benefits, plan design and language.
• Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills.

Responsibilities

• Optimizes interactions with providers and internal partners to maintain relationships.
• Monitors service capabilities and resolves issues related to claims, contracts and demographics.
• Supports operational activities such as database management and contract coordination.
• Performs credentialing support activities as needed.
• Educates providers to ensure policy compliance and proper procedures.
• Meets with providers to ensure service levels meet expectations.
• Leads development of meeting agendas, validates materials, and facilitates external provider meetings.
• Collaborates cross-functionally on contract implementation or provider data updates.

Skills

Provider relations knowledge

Policy/benefits/plan language

Communication and problem solving

Education

Bachelor's degree or equivalent experience

Job description

CVS Health is seeking a provider relations professional to act as the primary resource for high profile providers or groups, on-site as needed, and to oversee contracts, plan design, and provider education to ensure policy compliance and service excellence. You will work with internal teams to resolve complex issues and maintain positive relationships.

The role requires 3–5 years of policy/benefit experience, a bachelor’s degree or equivalent, and strong communication skills, with a typical 40