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Sr Analyst,Ntwrk Relations ID-12408

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.

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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 business partner and operational activities that may include, but are not limited to, database management, introduction and expansion of programs, medical record retrieval, 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 virtually or in person with key providers periodically to ensure service levels are meeting expectations.
- Manages the development of meeting agendas, validates materials, coordinates business partner meeting attendance, maintains meeting minutes and facilitates external provider meetings.
- May collaborate cross-functionally on the implementation of contracts or provider demographic updates.

- Assist with standard provider recruitment, contracting, or re- contracting activities

Required Qualifications

-Working knowledge of business segment specific billing codes, reimbursement methodologies, plan products, knowledge of contracts and terminology
-3+ years' experience in business segment environment servicing providers with exposure to benefits, credentialing, experience with claims and billing and/or contract interpretation.
-Strong verbal and written communication, interpersonal, problem resolution, presentation and critical thinking skills.

Preferred Qualifications
-5+ years' experience in business segment environment servicing providers with exposure to benefits, credentialing, experience with claims and billing and/or contract interpretation.
Education
Bachelors degree or equivalent combination of education and experience

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