Senior Analyst, Network Relations

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
Acts as the primary resource for assigned, high profile providers or groups (i.e. local, individual providers, small groups/systems) 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.

- Optimizes interactions with assigned providers and internal business partners to establish and maintain productive, professional relationships.
- Monitors service capabilities and collaborates cross functionally to ensure that the needs of constituents are met and that escalated issues related but not limited to, claims payment, contract interpretation or parameters, and accuracy of provider contract or demographic information are resolved.

- Supports or assists with business partner and operational activities that may include, but are not limited to, database management, introduction and expansion of programs, medical record retrieval, and contract coordination.
- Performs credentialing support activities as needed.
- Educates providers as needed to ensure compliance with contract policies and parameters, plan design, compensation process, technology, policies, and procedures.
- Meets virtually or in person with key providers periodically to ensure service levels are meeting expectations.
- Manages the development of meeting agendas, validates materials, coordinates business partner meeting attendance, maintains meeting minutes and facilitates external provider meetings.
- May collaborate cross-functionally on the implementation of contracts or provider demographic updates.
- Assist with standard provider recruitment, contracting, or re- contracting activities

Required Qualifications

-Working knowledge of business segment specific billing codes, plan products, and terminology.
-3+ years' experience in business segment environment servicing providers with exposure to benefits, credentialing, experience with claims and billing and/or contract interpretation.
-Strong verbal and written communication, interpersonal, problem resolution, presentation and critical thinking skills.
Preferred Qualifications
5+ years' experience in business segment environment servicing providers with exposure to benefits, credentialing, experience with claims and billing and/or contract interpretation

Education
Bachelors 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:

$46,988.00 - $102,000.00

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 schedules, family leave, dependent care resources, colleague assistance pro