CVS Health · 22 hours ago
Network Relations, Senior Analyst
United States
Full-time
Remote
Mid, Senior Level
$47K/yr - $102K/yr
5+ years expCVS Health is dedicated to building a world of health around every individual, prioritizing a connected and compassionate health experience. They are seeking a Senior Analyst for the Provider Engagement Network Solutions Team to manage provider inquiries and ensure compliance in network participation. The role involves claims management, provider data maintenance, and credentialing coordination among other responsibilities.
Health CareMedicalPharmaceuticalRetailSales
Responsibilities
Claims Management: Investigate and resolve provider claim issues, ensuring timely and accurate adjudication
Provider Data Maintenance: Submitting demographic changes and updates to maintain accurate provider records in all systems
Contracting & Agreement Support (PPO only): Handle Complaints grievance and appeals requests, including contract generation and amendments for PPO networks
Network Participation Requests: Manage opt-in and opt-out requests for provider participation in various networks
Credentialing Coordination: Facilitate credentialing requests and ensure compliance with organizational and regulatory standards
Regulatory & Compliance Support: Collaborate with DOI (Department of Insurance) and SIU (Special Investigations Unit) for compliance matters and fraud prevention
Provider Education: Deliver guidance and training to providers regarding policies, procedures, and online portal navigation
Electronic Payment Setup: Send EFT (Electronic Funds Transfer), ERA (Electronic Remittance Advice), and VCC (Virtual Credit Card) enrollment requests for processing
Qualification
Required
Bachelor's degree in dental, healthcare administration, business, or related field (or equivalent experience)
5+ years of experience in dental, provider relations, network management, or healthcare operations/administration
Strong understanding of PPO networks, credentialing processes, and claims administration
Excellent communication and problem-solving skills
Proficiency in MS Office and provider management systems
Detail-oriented with strong organizational skills
Ability to manage multiple priorities in a fast-paced environment
Knowledge of regulatory requirements and compliance standards
Customer focused with a commitment to service excellence
Preferred
Experience in the dental field and knowledge of PPO, and Medicare networks
Benefits
Affordable medical plan options, a 401(k) plan (including matching company contributions), and an 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.
Company
CVS Health
CVS Health is a health solutions company that provides an integrated healthcare services to its members.
10001+ employees
H1B Sponsorship
CVS Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2022 (1)
Funding
Current Stage
Public CompanyTotal Funding
$4BKey Investors
Michigan Economic Development CorporationStarboard Value
2025-08-15Post Ipo Debt· $4B
2025-07-17Grant· $1.5M
2019-11-25Post Ipo Equity
Leadership Team
David Joyner
President and Chief Executive Officer, CVS Health
Chandra McMahon
SVP & CISO
Recent News
The Motley Fool
2026-01-22
bloomberglaw.com
2026-01-22
Company data provided by crunchbase