Senior Analyst, Network Relations
Company: CVS Health
Posted on: May 26, 2023
Acts as the NY/NJ regional recruitment lead whose main task will be the primary resource for recruiting nonparticipating providers into the Aetna network based on high profile employer group requests. This person will establish positive relationships with our provider partners and once terms are agreed upon, they will ensure that providers seamlessly move through the onboarding process. They will act as a resource for any questions related to plan policies and terms. -Optimizes interactions with assigned providers andinternal business partners to establish and maintainproductive, 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 informationare resolved.-Supports or assists with operational activities that may include, but are not limited to, database management, andcontract coordination.-Performs credentialing support activities as needed.-Educates providers as needed to ensure compliance withcontract policies and parameters, plan design,compensation process, technology, policies, andprocedures.-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 implementationof contracts or provider demographic updates
The typical pay range for this role is:
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
-Working knowledge of billing, coding, products, and terminology.-1-3 years' experience in health insurance or provider relations.-Strong verbal and written communication, interpersonal,problem resolution and critical thinking skills.- Microsoft Excel fluency is a must
1-3 years' experience in business segment environmentservicing providers with exposure to benefits and/orcontract interpretation.
-Bachelors degree or equivalent combination of educationand experience.
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. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Keywords: CVS Health, Newark , Senior Analyst, Network Relations, Professions , Newark, New Jersey
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