Senior Network Relations Specialist

3 weeks ago


Olympia, Washington, United States CVS Health Full time

Job Summary

CVS Health is seeking a highly skilled Network Relations Specialist to join our team. As a key member of our organization, you will be responsible for acting as a primary resource for all dental products, including DHMO, PPO, and Medicare, for providers, sales, and marketing, and Dental Service Centers to aid in the achievement of Aetna Key Performance Measures.

Key Responsibilities

  • Act as a liaison with Primary Care Dentists and Specialists in a specific geographic territory responsible for overall maintenance and territory management of the provider network.
  • Negotiate contract language and provider compensation.
  • Review quality and service reports with providers and staff, contacting Dental providers regarding quality reviews conducted where unacceptable results were obtained.
  • Timely response to correspondence from Provider offices, including termination requests, tax ID changes, hold requests, claim reimbursement, system, directory accuracy, and various contractual issues.
  • Documented resolution and follow-through communicated to all parties.
  • Presentation of DHMO and PPO plan design, compensation process, claim/encounter submission, and referral policies during new office orientations and reorientations via the telephone.

Requirements

  • 5 years of experience in sales, service, dental office, and/or payor setting.
  • Strong verbal and written communication skills.
  • Preferred qualifications include experience in the dental field and knowledge of PPO, DMO, and Medicare networks.
  • Bachelor's degree or relevant experience.

What We Offer

CVS Health offers a competitive salary range of $46-$112,200.00, as well as a comprehensive benefits package, including medical, dental, and vision benefits, 401(k) retirement savings plan, and employee stock purchase plan. We also offer numerous well-being programs, education assistance, free development courses, CVS store discount, and discount programs with participating partners.

CVS Health is an Equal Opportunity Employer

We are committed to diversity, equity, and inclusion. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.



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