Network Relations Manager- Oklahoma

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Position Summary : Acts as the primary resource for assigned, high profile providers and / 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 Medicaid 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 operational activities that may

include, but are not limited to, database management,

and contract coordination

• Performs credentialing support activities as needed
• Educates Medicaid providers as needed to ensure

compliance with contract policies and parameters, plan

design, compensation process, technology, policies, and

procedures

Meets with key providers regular intervals to ensure

service levels are meeting expectations

Manages the development of agenda, validates

materials, and facilitates external provider meetings

Collaborate cross-functionally on the

implementation of large provider systems, to manage

cost drivers and execute specific cost initiatives to

support business objectives and to identify trends and

enlist assistance in problem resolution

Assist with standard provider recruitment, contracting, or

re- contracting activities and assist with more complex

contracting and discussions as needed by business

segment

May provide guidance and training to less experienced

team members

• Travel required
• Other duties as assigned

Required Qualifications

3+ years' experience in Medicaid Managed Care

business segment environment servicing providers with

exposure to benefits and / or contract interpretation

Strong verbal and written communication, interpersonal,

problem resolution and critical thinking skills

Working knowledge of business segment specific codes,

products, and terminology

Travel is required

Preferred Qualifications

• Comfortable presenting to small and large groups
• Advanced use of Excel / Word / Adobe
• Preferred location Oklahoma

Education

Bachelor's degree or equivalent experience

Pay Range

The typical pay range for this role is :

$54,300.00 - $119,300.00

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.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.

The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.

The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits.

CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.

As for time off, Company employees enjoy Paid Time Off ( PTO ) or vacation pay, as well as paid holidays throughout the calendar year.

Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.