Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand — with heart at its center — our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
 
Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

This role acts as the primary resource for an assigned profile of large provider groups/health systems to establish, oversee, and maintain provider risk management and positive relationships and supports high value initiative activities. Drives the implementation of internal and external solutions to achieve 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 related 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 all levels.

• A minimum of 3 years’ experience in business segment specific environment servicing or managing non-standard relationships with providers with exposure to benefit plan design and/or contract interpretation.

• Working knowledge of business segment specific codes, products, and terminology.

• Proven advanced problem solving skills, conflict management, an independent worker and self-starter.

• Must be willing to travel 10-15% to providers.

Preferred Qualifications

• Ability to educate 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.

Pay Range

The typical pay range for this role is:

$60,300.00 - $159,120.00

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.  
 
For more detailed information on available benefits, please visit Benefits | CVS Health

We anticipate the application window for this opening will close on: 12/21/2024

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.