Manager, Network Relations

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Requisition Job DescriptionPosition Summary

This role acts as the primary resource for an assigned profile of large provider groups/health 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.

• Optimizes interactions with assigned providers and internal business partners to establish and maintain productive, professional relationships.
• Manges provider servicing matters; collaborates cross-functionally to ensure that the needs of constituents are met by driving resolutions for escalated issues related to claims payment, policies, accuracy of provider demographic information and contract interpretation.
• Educates providers to ensure compliance with contract parameters, plan design, compensation process, technology, policies, and procedures.
• Manages the development of agendas, validates materials, and facilitates external provider meetings to ensure service levels are meeting expectations.
• May collaborate cross functionally to manage cost drivers and execute specific cost initiatives to support business objectives and identify trends to enlist assistance in problem resolution.
• Other duties as assigned

• Strong verbal and written communication, interpersonal, conflict resolution and critical thinking skills with proven ability to influence and collaborate with providers and partners at all levels.
• 3 to 5 years of provider relations experience- non-standard relationships with providers with exposure to benefit plan design and/or contract interpretation.
• Working knowledge of business segment specific CPT and HCPC codes, products, and terminology.
• Proven advanced problem-solving skills, conflict management, an independent worker and self-starter.
• Prior Medicare and Commercial insurance experience
• Must be willing to travel 10-15% to providers.
• Ability to work remotely, in the Virginia, Maryland, or District of Columbia area.

• Ability to educate an outcome or position even if unfavorable.
• Ability to evaluate data and identify action plans or solutions based on data.

• Bachelor's degree or equivalent professional work experience.

• 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.