CVS Health is a leading healthcare company operating CVS Specialty, CVS Pharmacy, CVS MinuteClinic, and CVS Caremark. In 2018, CVS combined forces with healthca
Senior Manager, Provider Relations
Location
Texas
Posted
1 day ago
Salary
$75.4K - $166.0K / year
Seniority
Senior
Job Description
Senior Manager, Provider Relations
CVS Health
• Provides strategic leadership and oversight for network management and provider relations • Develops and implements network strategies, monitors provider performance metrics • Leads dispute resolution processes and collaborates with key stakeholders to drive network growth • Assists in creation of reports, attends, and presents at Plan committee meetings • Conducts shadowing during provider visits on-site, virtual, telephonic • Monitors after-visit provider survey • Collaborates with leadership to maintain and update policies and procedures • Assists Providers by resolving inquiries and educating Providers on new protocols, policies, and procedures • Actively participates in State and regulatory audits • Conference participation, as needed • Leads process improvement initiatives across the Provider Engagement team to increase operational efficiency, provider satisfaction, and compliance • Identifies gaps, streamlines workflows, and implements standardized processes to support PE team objectives • Develops and maintains operational procedures, desktop guides, and best practices for the PE team • Monitors performance metrics and recommends improvements to engagement strategies and team effectiveness • Monitors Texas Health and Human Services Commission (HHSC) updates, requirements, and regulatory changes impacting provider operations • Translates regulatory requirements into actionable guidance for the Provider Engagement team • Develops, updates, and maintains PE desktop procedures, reference materials, and training resources • Ensures provider-facing communications and educational materials align with state directives and organizational standards
Job Requirements
- A minimum of 7 years' work experience in healthcare
- Must have working knowledge of Medicaid
- A minimum of 2 years leadership/management experience leading / managing staff to ensure department goals are met
- Must have provider facing experience
- Travel within Market as needed
- This position must reside in Texas within driving distance of HHSC State buildings.
Benefits
- medical, dental, and vision coverage
- paid time off
- retirement savings options
- wellness programs
- other resources, based on eligibility
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