Network Relations Consultant, CVS Health

CVS Health

Location:
United States, Work at Home

Category:
Customer Service

Contract Type:
Employment contract

Salary:

46988.00 - 91800.00 USD / Year

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Job Description:

The Network Relations Consultant acts as the primary resource for assigned, high profile providers or groups to establish, oversee, and maintain positive relationships by assisting with or responding to complex issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs.

Job Responsibility:

Act as primary resource for assigned providers or groups
Conduct initial provider orientations and ongoing educational outreach
Conduct Provider Forums
Educate providers regarding policies and procedures
Enhance account relationships by investigating and resolving provider matters
Act as liaison between provider and health plan
Monitor service capabilities and collaborate with cross-functional departments
Support operational activities including database management and contract coordination
Submit Updates to Demographics or Roster modifications
Ensure compliance of health plan, corporate, state, and federal regulations
Provide responsive and professional customer service
Escalate issues to management
Meet productivity standard of 10-12 provider visits a week
Conduct site visits when required

Requirements:

Candidates are to reside within the State of Ohio
Minimum 3 years recent Healthcare Claims experience
Excellent analytical and problem-solving skills
Strong communication, and presentation skills
Strong Microsoft Office Suite experience (Word, Excel, TEAMs)
Must be able to travel
Associates degree or equivalent experience (HS diploma + 2 years relevant experience)

Nice to have:

Recent Managed Care Network experience in Provider Relations or Network Relations
Behavioral Health experience
Medicaid experience
Strong Microsoft Word, and Excel experience preferred

What we offer:

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
Wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and financial coaching
Paid time off
Flexible work schedules
Family leave
Dependent care resources
Colleague assistance programs
Tuition assistance
Retiree medical access

Additional Information:

Job Posted:
October 15, 2025

Expiration:
October 29, 2025

Employment Type:

Fulltime

Work Type:

Remote work

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Network Relations Consultant