Network Relations, Senior Analyst

CVS Health

3d

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. Acts as the primary liaison for assigned geography of integrated providers, (i.e. market/regional/national, 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.

Requirements

• 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

Nice To Haves

• 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
• Must be flexible and able to handle a highly, fast-paced environment

Responsibilities

• Acts as the primary liaison for assigned geography of integrated providers
• Establish, oversee, and maintain provider risk management and positive relationships
• 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.

Benefits

• 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 for this position 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees