Provider Relations Specialist

2 weeks ago


Columbus, Ohio, United States CVS Health Full time
Join CVS Health and Make a Difference

At CVS Health, we are united by a clear mission: to enhance every moment of health for our customers. Our commitment to delivering personalized, human-centric healthcare is at the heart of everything we do.

Position Overview

The Provider Relations Specialist serves as the key point of contact for designated high-profile healthcare providers or groups. This role is essential in fostering and maintaining strong relationships by addressing complex inquiries related to policies, plan structures, contract details, service, claims, and educational needs.

Key Responsibilities
  • Conduct initial orientations for providers and ongoing educational initiatives.
  • Facilitate Provider Forums in collaboration with the team.
  • Inform providers about policies regarding referrals, claims processing, credentialing, and technology integration.
  • Strengthen account relationships by investigating and resolving provider concerns effectively.
  • Act as a liaison between providers and the health plan to enhance financial and quality outcomes.
  • Monitor service capabilities and work with various departments to address escalated issues.
  • Support operational tasks including database management and contract coordination.
  • Ensure compliance with health plan regulations and corporate policies.
  • Deliver exceptional customer service to both internal and external stakeholders.
  • Meet established productivity standards through regular provider visits.
  • Travel as necessary for site visits and additional responsibilities.

Qualifications
  • Must reside within the State of Ohio.
  • A minimum of 3 years of recent experience in Managed Care Network or Provider Relations.
  • Strong analytical and problem-solving capabilities.
  • Excellent communication and presentation skills.
  • Preferred experience in Behavioral Health.
  • Proficiency in Microsoft Word and Excel.
  • Education: Associate's degree or equivalent professional experience.

Compensation and Benefits

The typical pay range for this role is between $43,000 and $102,000 annually. The actual salary will be determined based on various factors including experience and education.

CVS Health offers a comprehensive benefits package, including medical, dental, and vision coverage, a 401(k) retirement savings plan, and an Employee Stock Purchase Plan. Additional benefits include life insurance, disability coverage, well-being programs, education assistance, and employee discounts.

At CVS Health, we are proud to be an equal opportunity employer, committed to creating a diverse and inclusive workplace.

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