Provider Relations Liaison- Hybrid Michigan
Bring your heart to CVS Health.
Every one of us at CVS Health shares a single, clear purpose:
Bringing our heart to every moment of your health.
This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world.
Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors support this purpose.
We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
Position SummaryThe Network Relations Manager acts as the primary resource for assigned, high profile providers or groups (i.
e.
local, individual providers, small groups/systems) to establish, oversee, and maintain positive relationships by assisting with or responding to complex issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs.
The Network Relations Manager is responsible for the following:
Acts as the primary resource for assigned profile of providers (i.
e.
individual providers, groups, and/or large healthcare systems) to establish, oversee, and maintain provider risk management and positive relationships and supports high value initiative activities; Drives the implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets; Cultivate productive relationships with providers ; - Deliver presentations and trainings to providers, both virtually and in-person; - Serve as the point of contact for designated provider profile and/or territory; - Resolve issues/concerns in an efficient and timely manner, including resolution of complex claims; - Support ad hoc reporting needs; - Identify and advocate for opportunities to improve the provider experience; Required Qualifications Must Reside in Michigan as local travel is required 50% Travel Minimum of 5 to 7 years' experience in Provider Relations servicing or managing non-standard relationships with providers with exposure to benefit plan design and/or contract interpretat Excellent interpersonal skills and the ability to work with others at all levels Knowledge of Regulatory Standards for Network Access, Credentialing, Claims Processing, Provider Appeals & Disputes and Network Performance Standards Excellent analytical and problem-solving skills Strong communication and presentation skills Preferred Qualifications 3
years' experience in business segment environment servicing providers with exposure to benefits and/or contract interpretation.
- Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills.
Education Bachelors degree or equivalent work experiencePay RangeThe typical pay range for this role is$60,300.
00 - $130,000.
00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.
The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.
The Company offers a full range of medical, dental, and vision benefits.
Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.
The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits.
CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.
As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year.
Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit jobs.
CVSHealth.
com/benefits CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment.
Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities.
As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions.
CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through email protected If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS).
We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.
Recommended Skills Analytical Claim Processing Communication Credentialing Critical Thinking Interpersonal Skills Estimated Salary: $20 to $28 per hour based on qualifications.
Every one of us at CVS Health shares a single, clear purpose:
Bringing our heart to every moment of your health.
This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world.
Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors support this purpose.
We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.
Position SummaryThe Network Relations Manager acts as the primary resource for assigned, high profile providers or groups (i.
e.
local, individual providers, small groups/systems) to establish, oversee, and maintain positive relationships by assisting with or responding to complex issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs.
The Network Relations Manager is responsible for the following:
Acts as the primary resource for assigned profile of providers (i.
e.
individual providers, groups, and/or large healthcare systems) to establish, oversee, and maintain provider risk management and positive relationships and supports high value initiative activities; Drives the implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets; Cultivate productive relationships with providers ; - Deliver presentations and trainings to providers, both virtually and in-person; - Serve as the point of contact for designated provider profile and/or territory; - Resolve issues/concerns in an efficient and timely manner, including resolution of complex claims; - Support ad hoc reporting needs; - Identify and advocate for opportunities to improve the provider experience; Required Qualifications Must Reside in Michigan as local travel is required 50% Travel Minimum of 5 to 7 years' experience in Provider Relations servicing or managing non-standard relationships with providers with exposure to benefit plan design and/or contract interpretat Excellent interpersonal skills and the ability to work with others at all levels Knowledge of Regulatory Standards for Network Access, Credentialing, Claims Processing, Provider Appeals & Disputes and Network Performance Standards Excellent analytical and problem-solving skills Strong communication and presentation skills Preferred Qualifications 3
years' experience in business segment environment servicing providers with exposure to benefits and/or contract interpretation.
- Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills.
Education Bachelors degree or equivalent work experiencePay RangeThe typical pay range for this role is$60,300.
00 - $130,000.
00This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.
The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.
The Company offers a full range of medical, dental, and vision benefits.
Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.
The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits.
CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.
As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year.
Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit jobs.
CVSHealth.
com/benefits CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.
You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment.
Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.
CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities.
As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions.
CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through email protected If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS).
We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.
Recommended Skills Analytical Claim Processing Communication Credentialing Critical Thinking Interpersonal Skills Estimated Salary: $20 to $28 per hour based on qualifications.
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