Senior Analyst, Network Relations

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

About the role

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 operational activities that may include, but are not limited to, database management, 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 with key providers periodically to ensure service levels are meeting expectations. Manages the development of agenda, validates materials, and facilitates external provider meetings. May 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. Conducts standard provider recruitment, contracting, or recontracting activities and assists with more complex contracting and discussions as needed by business segment. May provide guidance and training to less experienced team members.

Remote position within West Region

Responsibilities

• Act as the primary resource for assigned providers or groups to establish and maintain positive relationships.
• Assist with or respond to complex issues regarding policies, plan design, contract language, service, claims, or compensation.
• Optimize interactions with providers and internal business partners to maintain productive relationships.
• Monitor service capabilities and collaborate cross-functionally to resolve escalated issues.
• Support operational activities such as database management and contract coordination.
• Perform credentialing support activities as needed.
• Educate providers on compliance with contract policies, plan design, and procedures.
• Meet with key providers periodically to ensure service expectations are met.
• Manage the development of agendas, validate materials, and facilitate external provider meetings.
• Collaborate on the implementation of large provider systems to manage cost drivers and execute cost initiatives.
• Conduct provider recruitment, contracting, or recontracting activities.
• Provide guidance and training to less experienced team members.

Requirements

• 3-5 years of knowledge of business segment-specific codes, products, and terminology.
• 3-5 years of Microsoft Applications experience.
• Strong verbal and written communication, interpersonal, problem resolution, and critical thinking skills.
• Exceptional organizational, multitasking, and time management skills.
• Ability to balance competing priorities in a fast-paced environment.
• Capacity to assess urgent needs, adapt to changing demands, and manage multiple assignments while meeting deadlines.

Qualifications

• Bachelor’s Degree or equivalent combination of education and experience.

Preferred: 6+ years of knowledge of business segment-specific codes, products, and terminology.

Pay

The typical pay range for this role is $46,988.00 - $112,200.00. 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.

Schedule

• Anticipated weekly hours: 40
• Time type: Full time

Benefits

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. Benefits include:

• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs
• Other resources, based on eligibility