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.
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