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.

　　Position Summary

　　Acts as the primary resource for assigned, high profile providers or groups (i.e. local, individual providers, small groups/systems) to establish, oversee, and maintain positive relationships by assisting with or responding to complex issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs.

　　- Optimizes interactions with assigned providers and

　　internal business partners to establish and maintain

　　productive, 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

　　information are resolved.

　　- Supports or assists with operational activities that may

　　include, but are not limited to, database management,

　　and contract coordination.

　　- Performs credentialing support activities as needed.

　　- Educates providers as needed to ensure compliance

　　with contract policies and parameters, plan design,

　　compensation process, technology, policies, and

　　procedures.

　　- 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 implementation

　　of contracts or provider demographic updates.

　　Required Qualifications

　　- Working knowledge of business segment specific codes,

　　products, and terminology.

　　- 3-5 years' experience with business segment specific

　　policy, benefits, plan design and language.

　　Proven working knowledge of provider financial and

　　operational issues as they relate to health insurance

　　Team lead or project management experience to lead or

　　participate in projects or initiatives

　　Knowledge of current health insurance marketplace

　　Preferred Qualifications

　　3+ years' experience in business segment environment

　　servicing providers with exposure to benefits and/or

　　contract interpretation.

　　- Strong verbal and written communication, interpersonal,

　　problem resolution and critical thinking skills.

　　3+ years' experience in business segment environment

　　servicing providers with exposure to benefits and/or

　　contract interpretation.

　　- Strong verbal and written communication, interpersonal,

　　problem resolution and critical thinking skills.

　　Education

　　Bachelors degree or equivalent combination of education

　　and experience

　　Pay Range

　　The typical pay range for this role is:

　　$43,700.00 - $90,000.00

　　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 jobs.CVSHealth.com/benefits

　　CVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated.

　　You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.

　　CVS Health is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. CVS Health can provide a request for a reasonable accommodation, including a qualified interpreter, written information in other formats, translation or other services through [email protected] If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every effort to respond to your request within 48 business hours and do everything we can to work towards a solution.