Network Relations Manager
CVS Health
full-time
Posted on:
Location Type: Office
Location: Louisiana • United States
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Salary
💰 $54,300 - $119,340 per year
About the role
- Acts as the primary resource for assigned providers and/or groups to establish and maintain positive relationships
- Assists with complex issues regarding Medicaid policies and procedures, plan design, contract language, service, claims or compensation issues
- Optimizes interactions with assigned providers and internal business partners
- Monitors service capabilities and collaborates cross-functionally to ensure needs are met
- Supports operational activities such as database management and contract coordination
- Performs credentialing support activities as needed
- Educates Medicaid providers to ensure compliance with contract policies
- Meets with key providers regularly to ensure service levels meet expectations
- Manages the development of agenda and facilitates external provider meetings
- Collaborates cross-functionally for the implementation of large provider systems
Requirements
- Minimum of 3 years' experience in Medicaid Managed Care business segment environment servicing providers
- Minimum of 2 years’ experience working with providers and contracts in the behavioral health sector
- A minimum of 5 years' work experience in healthcare
- Working knowledge of business segment specific codes, products, and terminology
- Travel within the defined territory up to 50-80% of the time
- Candidates must reside in the state of Louisiana and within one of the following parishes: St. Landry, Evangeline, Acadia, Lafayette, St. Martin, Iberia, Vermilion, Avoyelles, Rapides, Vernon, Grant, Winn, LaSalle, Catahoula, Concordia, Sabine, Natchitoches, DeSoto, Red River, Caddo, Bossier, Webster, Claiborne, Bienville.
Benefits
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Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
database managementcredentialing supportMedicaid policiescontract coordinationclaims managementservice optimizationprovider systems implementationbehavioral health contractshealthcare experiencebusiness segment specific codes
Soft Skills
relationship managementcollaborationcommunicationproblem-solvingfacilitationorganizational skillseducational skillsservice level managementcross-functional teamworkagenda development