Medicaid Behavioral Health Provider Relationship Manager

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 colleagues who care deeply, innovate with purpose, hold themselves accountable and prioritize safety and quality in everything they do.

Job Summary: This is an individual contributor role acting as the primary resource for assigned, high-profile Behavioral Health providers and/or groups to establish, oversee, and maintain positive relationships.

Key Responsibilities:

• Optimise interactions with assigned providers and internal business partners to establish and maintain productive, professional relationships.
• Monitor service capabilities and collaborate cross-functionally to ensure that the needs of constituents are met and that escalated issues are resolved.
• Support operational activities such as database management and contract coordination.
• Perform credentialing support activities as needed.
• Educate Medicaid providers to ensure compliance with contract policies and parameters.
• Meet with key Providers at regular intervals to ensure service levels meet expectations.
• Manage the development of agenda, validate materials, and facilitate external provider meetings.
• Collaborate cross-functionally with the implementation of large provider systems.
• Provide guidance and training to less experienced team members.
• Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills.
• Collaborate with Provider Enablement & Strategy on Provider-facing communications.

Required Qualifications:

• A minimum of 5 years' work experience in healthcare.
• Minimum of 3 years' experience in Medicaid Managed Care business segment environment.
• Minimum of 2 years’ experience working with providers and contracts in the behavioral health sector.
• Working knowledge of business segment specific codes, products, and terminology.
• Proficiency in Microsoft Office Suite.
• Travel within the defined territory up to 50-80% of the time.
• Candidates must reside in the state of Louisiana and within one of the specified parishes.

Preferred Qualifications:

• Knowledge of Medicaid Regulatory Standards.
• Experience in Medical Terminology, CPT, ICD-10 codes.

Education:

• Bachelor's degree preferred or a combination of professional work experience and education.

Anticipated Weekly Hours: 40

Time Type: Full time

Pay Range: $54,300.00 - $119,340.00

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.