Network Relations Specialist

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.

Position Summary

• The Network Relations Specialist is a key role within the Network Operations function. 
• The role is responsible for supporting Aetna’s provider network by facilitating new provider applications, managing provider inquiries and assistance requests, and ensuring provider data and demographic information is maintained current. 
• The role is an individual contributor position, but part of a broader team of colleagues with similar responsibilities. 

Key Responsibilities 

• Manage the provider application / onboarding process and workflow within internal systems, ensuring information is collected and documented against workflow standards. 
• Role is responsible for achieving production volume standards as defined by department management, and may only focus on specific aspects of the provider application / inquiry / data integrity processes (as defined by management)  
• Role will be oriented to specific workflow supporting these tasks, and will generally follow these workflow expectations towards production expectations  
• Respond to provider inquiries (Network Assistance Form tickets) spanning several types of inquiries (ex: status of their application) 
• Role will conduct necessary independent research/outreach/steps to resolve provider situations within specified turnaround times 
• Research provider requests for demographic data maintenance to validate accuracy of change request and/or if more information may be needed.  Interact with provider to close information gaps where necessary.  
• Work with internal cross-functional partners to submit information updates into various provider data systems  
• Ensure accuracy of our provider applications, inquiry responses, and all corresponding data by engaging in related review and audit processes  
• Role will interact with external providers and must demonstrate appropriate professionalism and communication standards

Required Qualifications

• 2-5 years data entry experience
• 1-2 years of customer service experience
• Microsoft Office applications experience

Preferred Qualifications

• Knowledge of PRMS and EPDB or Smart Front End
• Strong communication, critical thinking, problem resolution and interpersonal skills. 

Education

• Associate degree or equivalent combination of education and experience. 

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$18.50 - $35.29

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.  The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. 
 

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• 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 sch