Provider Relations Liaison- Detroit market

CVS Health•Field-Michigan, MI

4d•Onsite

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. The Provider Relations Liaison serves as the primary point of contact for assigned, high-profile providers and provider groups (including individual providers and small group practices). This role is responsible for establishing, strengthening, and maintaining productive, long-term relationships by proactively addressing complex issues related to policies and procedures, plan design, contract language, claims, compensation, and provider education. The role collaborates closely with internal business partners to resolve escalated concerns, ensure operational excellence, and deliver a consistent, high-quality provider experience.

Requirements

3+ years of external-facing customer service or relationship management experience, preferably in a healthcare, insurance, or benefits-related environment.
3+ years of experience working with business-segment-specific policies, benefits, plan design, and contract language.
Working knowledge of provider-related codes, products, and industry terminology.
Demonstrated ability to manage complex issues, prioritize competing requests, and meet service expectations.
Strong verbal and written communication skills with the ability to convey complex information clearly and professionally.
Proven problem-solving, critical thinking, and relationship-building skills.
Proficiency with standard business technology and data systems (e.g., CRM platforms, databases, or claims systems).

Nice To Haves

3+ years of experience supporting or servicing healthcare providers, including exposure to benefits administration and contract interpretation.
Experience working with provider networks, claims operations, credentialing, or provider contracting.
Familiarity with healthcare compliance requirements and regulatory guidelines.
Ability to analyze service trends and recommend process improvements.
Experience facilitating provider meetings or leading cross-functional initiatives.

Responsibilities

Serve as the primary relationship manager for assigned providers, acting as a trusted advisor and advocate.
Manage and resolve complex provider issues, including but not limited to: Claims payment discrepancies, Contract interpretation and compliance, Provider compensation questions, Demographic and contract data accuracy.
Partner cross‑functionally with Operations, Claims, Contracting, Credentialing, and other internal teams to drive timely issue resolution and continuous improvement.
Monitor service performance and trends, identifying opportunities to enhance provider satisfaction and operational efficiency.
Support operational activities such as: Contract coordination, Provider database maintenance, Reporting and documentation.
Perform credentialing-related support activities as needed.
Educate providers on: Contract terms and requirements, Plan design and benefits, Compensation processes, Technology platforms, policies, and procedures.
Conduct periodic meetings (virtual or in-person) with key providers to review service performance and address concerns.
Develop meeting agendas, validate presentation materials, and facilitate external provider meetings.
Collaborate with internal stakeholders on provider onboarding, contract implementations, and demographic updates.