Network Relations, Senior Analyst
CVS Health, Raleigh, NC, United States
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.
Responsibilities
Acts as the primary liaison for assigned geography of integrated providers (i.e. market/regional
ational, large group) to establish, oversee, and maintain provider risk management and positive relationships and supports high value initiative activities.
Conducts provider education, ensures contract compliance, provider communication, claims research and assists with resolution.
Implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets.
Required Qualifications
Experienced in working with all reimbursement payment methodologies.
3-5 years of provider relations and/or network management experience required.
Experienced in working with large provider groups, capitated agreements, behavioral health provider.
Must have excellent written, oral, and interpersonal communication skills.
Computer literate in Word, Excel, Microsoft Office.
Must be flexible and able to handle a highly, fast‑paced environment.
Must reside in North or South Carolina.
Preferred Qualifications
Knowledge of Medicare programs.
Knowledge of various Behavioral Health and Commercial payment methodologies.
Medical claims processing knowledge.
Experience working within Provider Databases (i.e. EPDB) a plus.
Critical thinking, problem resolution and ability to work independently.
Excellent time management skills.
Education
Associate Degree or equivalent combination of education and experience.
Compensation and Benefits Anticipated Weekly Hours: 40 Time Type: Full time
Pay Range: $46,988.00 - $91,800.00. This 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.
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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Responsibilities
Acts as the primary liaison for assigned geography of integrated providers (i.e. market/regional
ational, large group) to establish, oversee, and maintain provider risk management and positive relationships and supports high value initiative activities.
Conducts provider education, ensures contract compliance, provider communication, claims research and assists with resolution.
Implementation of internal and external solutions to achieve provider satisfaction, cost targets, network growth, and efficiency targets.
Required Qualifications
Experienced in working with all reimbursement payment methodologies.
3-5 years of provider relations and/or network management experience required.
Experienced in working with large provider groups, capitated agreements, behavioral health provider.
Must have excellent written, oral, and interpersonal communication skills.
Computer literate in Word, Excel, Microsoft Office.
Must be flexible and able to handle a highly, fast‑paced environment.
Must reside in North or South Carolina.
Preferred Qualifications
Knowledge of Medicare programs.
Knowledge of various Behavioral Health and Commercial payment methodologies.
Medical claims processing knowledge.
Experience working within Provider Databases (i.e. EPDB) a plus.
Critical thinking, problem resolution and ability to work independently.
Excellent time management skills.
Education
Associate Degree or equivalent combination of education and experience.
Compensation and Benefits Anticipated Weekly Hours: 40 Time Type: Full time
Pay Range: $46,988.00 - $91,800.00. This 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.
We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
#J-18808-Ljbffr