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CVS Health · 2 weeks ago

Network Relations Manager (Remote FL - Palm Beach, Indian River, St. Lucie, or Martin Counties )

United States

Full-time

Remote

Mid, Senior Level

$54K/yr - $119K/yr

5+ years exp

CVS Health is a leading health solutions company dedicated to transforming health care. The Network Relations Manager will act as the primary resource for assigned providers, optimizing interactions and maintaining productive relationships while addressing complex issues and contributing to the expansion of the provider network.

Health CareMedicalPharmaceuticalRetailSales

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

Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills

Other duties as assigned

Qualification

Healthcare experienceManaged Care experienceContract managementMS Office proficiencyBilingual in SpanishProblem resolutionCommunication skillsInterpersonal skillsCritical thinking

Required

A minimum of 5 years' work experience in healthcare

Minimum of 3 years' experience in Managed Care 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 in Palm Beach, Indian River, St. Lucie, or Martin Counties

Preferred

Bilingual in Spanish highly preferred

Proficient in the MS Office Suite and other advanced technologies

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