Network Relations Manager, CVS Health

CVS Health

Location:
United States, New Jersey

Category:
-

Contract Type:
Employment contract

Salary:

72360.00 - 159120.00 USD / Year

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Job Description:

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

Job Responsibility:

Acts as primary resource for assigned providers to establish and maintain positive relationships
Optimizes interactions with assigned providers and internal business partners
Monitors service capabilities and collaborate cross-functionally
Supports operational activities including database management and contract coordination
Performs credentialing support activities
Educates Medicaid providers on compliance
Meets with key Providers at regular intervals
Manages development of agenda and facilitates external provider meetings
Collaborate cross-functionally with implementation of large provider systems

Requirements:

Minimum of 5 years' work experience in healthcare
Minimum of 3 years' experience in Medicaid Managed Care business segment environment servicing providers with exposure to benefits and/or contract interpretation
Working knowledge of business segment specific codes, products, and terminology
Travel within the defined territory up to 50-80% of the time
Bachelor's degree preferred or a combination of professional work experience and education

Nice to have:

Knowledge of Medicaid Regulatory Standards for Network Access, Credentialing, Claim Lifecycle, Provider Appeals & Disputes, and Network Performance Standards
Experience in Medical Terminology, CPT, ICD-10 codes

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:
September 12, 2025

Expiration:
October 29, 2025

Employment Type:

Fulltime

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Network Relations Manager