Hybrid Network Relations Manager

at CVS Health

• Job title: Network Relations Manager
• Job type: Full Time
• Experience level: Mid level, Senior
• Salary: $60,300 - $132,600 per year
• Degree requirement: Bachelor's Degree
• Location requirements: Hybrid, Plantation, United States

About the role

• Network Relations Manager focused on maintaining relationships with healthcare providers at CVS Health. Collaborating with stakeholders to streamline processes and enhance provider experiences.

Responsibilities

• Acts as the primary resource for assigned providers and/or groups to establish, oversee, and maintain positive relationships by assisting with or responding to complex issues, regarding policies and procedures, contract language, service, claims or compensation issues, and provider education needs
• Optimizes interactions with assigned providers and internal business partners to establish and maintain productive, professional relationships
• Meets with key Providers at regular intervals to ensure service levels meet expectations
• Collaborates with internal stakeholders to address provider-related issues, streamline processes, and improve the overall provider experience within the organization
• Contributes to the development and expansion of the healthcare organization's provider network by identifying and recruiting new providers who align with the organization's needs and strategic objectives
• Coordinates the contracting process with healthcare providers to negotiate contract terms, fee schedules, reimbursement rates, and other contractual arrangements
• Assists with the development of provider education programs by organizing meetings, webinars, or training sessions to enhance providers' understanding of the organization's requirements, quality standards, and best practices
• Handles provider-related issues, concerns, and disputes to maintain positive relationships and ensure compliance with contractual agreements
• Supports or assists with operational activities that may include, but are not limited to, database management, and contract coordination
• Performs limited credentialing support activities as needed
• Manages the development of agenda, validates materials, and facilitates external provider meetings.

Requirements

• A minimum of 3 years work experience in healthcare
• Minimum of 5 years' experience in Managed Care & Medicare business segment environment servicing providers with exposure to contracting and contract management
• Working knowledge of business segment, products, and terminology
• Travel within the defined territory up to 30% - 50% of the time
• Candidates must reside in Florida, specifically Miami-Dade or Broward counties
• Bilingual in Spanish highly preferred
• Proficient in the MS Office Suite and other advanced technologies
• Bachelor's degree preferred or a combination of professional work experience and education.

Benefits

• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.