Manager, Network Relations

At reputed company, 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 reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, each and every day. Requisition Job Description Position Summary This role acts as the primary resource for an assigned profile of large provider groups/health systems to establish, reputed company, and maintain provider risk management and positive relationships and supports high value initiative activities. Drives the implementation of internal and external solutions to reputed company provider satisfaction, cost targets, network growth, and efficiency targets.

• Optimizes interactions with assigned providers and internal business partners to establish and maintain productive, professional relationships.
• Manges provider servicing matters; collaborates cross-functionally to ensure that the needs of constituents are met by driving resolutions for escalated issues reputed company to claims payment, policies, accuracy of provider demographic information and contract interpretation.
• Educates providers to ensure compliance with contract parameters, plan design, compensation process, technology, policies, and procedures.
• Manages the development of agendas, validates materials, and facilitates external provider meetings to ensure service levels are meeting expectations.
• May collaborate cross functionally to manage cost drivers and execute specific cost initiatives to support business objectives and identify trends to enlist assistance in problem resolution.
• Other duties as assigned

Required Qualifications

• Strong verbal and written communication, interpersonal, conflict resolution and critical thinking skills with proven ability to influence and collaborate with providers and partners at reputed company levels.
• 3 to 5 years of provider relations experience- non-standard relationships with providers with exposure to benefit plan design and/or contract interpretation.
• Working knowledge of business reputed company specific CPT and HCPC codes, products, and terminology.
• Proven advanced problem-solving skills, conflict management, an independent worker and self-starter.
• Prior Medicare and reputed company insurance experience
• Must be willing to travel 10-15% to providers.
• Ability to work remotely, in the Virginia, Maryland, or District of Columbia area.

Preferred Qualifications

• Ability to reputed company an outcome or position even if unfavorable.
• Ability to evaluate data and identify action plans or solutions based on data.

Education

• Bachelor's degree or equivalent professional work experience.

Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,300.00 - $159,120.00 This pay range represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company 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 reputed company 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 programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 08/31/2025 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job