Network Relations Manager (Pennsylvania)

CVS Health

1d

About The Position

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. Position Summary Acts as the primary resource for assigned profile of larger and more complex providers (i.e. market/regional/national, large group or hospital 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. May have limited contract negotiation responsibilities for assigned providers.

Requirements

• A minimum of 5 years' experience in business segment specific environment servicing or managing non-standard relationships with providers with exposure to benefit plan design and/or contract interpretation.
• A minimum of 3 years' experience with business segment specific policy, benefits, plan design and language.
• Candidates must reside in Pennsylvania, Southern New Jersey, or the Delaware.

Nice To Haves

• Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills with proven ability to influence and collaborate with providers and partners at all levels.
• Working knowledge of business segment specific codes, products, and terminology.

Responsibilities

• Optimizes interactions with assigned providers and internal business partners to establish and maintain productive, professional relationships and partners on the development of business strategy and programs to support the operational plans.
• Collaborates cross-functionally to ensure resolution of escalated issues or projects for assigned provider systems and monitors performance and adherence to scorecards and payout schedules based on established quality, growth and clinical measures.
• Educates internal and external parties as needed to ensure compliance with contract policies and parameters, plan design, compensation process, technology, performance measurement techniques, policies, and procedures.
• Meets with key providers periodically to ensure service levels are meeting expectations.
• Manages the development of agenda, validates materials, and facilitates external provider meetings.
• May collaborate cross functionally on the implementation of large provider systems, to manage cost drivers, data reports and execute specific cost initiatives to support business objectives and to identify trends and enlist assistance in problem resolution.
• May have limited contract negotiation responsibilities for assigned providers.
• May provide guidance and training to less experienced team members.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level