Network Relations Manager (California)

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 profile of providers (i.e. individual providers, groups, IPAs, and/or large healthcare 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

- Cultivate productive relationships with providers ;
- Deliver presentations and trainings to providers, both virtually and in-person;
- Serve as the point of contact for designated provider profile and/or territory;
- Resolve issues/concerns in an efficient and timely manner, including resolution of complex claims;
- Support ad hoc reporting needs;
- Identify and advocate for opportunities to improve the provider experience;
- Provider recruitment; possible contract negotiation for new or assigned providers.
Required Qualifications

- Minimum 2 years working knowledge of business segment specific codes, products, and terminology, including knowledge of both Commercial and Medicare Advantage business
- Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills with proven ability to influence and collaborate with providers and partners at all levels.
- Proven ability to manage complex provider partnerships and ability to amicably resolve provider disputes.
- Ability to evaluate data and identify action plans or solutions based on data;

- Comfortable presenting to small and large groups

- Be an active team contributor.

- Preference is for this candidate to reside in California

Preferred Qualifications

- Billing and Coding experience

- Advanced use of Excel/Word/Adobe

Education

Bachelor's degree preferred/specialized training/relevant professional qualification

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$66,330.00 - $145,860.00

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 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 close on: 04/30/2025

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