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
- Deploy and support the Medicaid Provider Engagement program.
- Reviews, learns, and participates with operations teams regarding policy and procedures related to claims/providers.
- Assist with the monitoring of executed provider contracts to ensure Network Access meets State requirements.
- Coordinates provider information with Provider Data Services including Member Services and other internal departments as requested as Provider Demographics are updated.
- Supports providers by resolving problems and advising providers of new protocols, policies, and procedures.
- Deliver training materials for staff and provider network. Participates as need for initial and ongoing provider in-services and provider education.
- Participates, when requested, in Grievance and Appeals meetings, and/or assists with tracking and trending provider grievances,
- Assists as requested for responses for all governmental, regulatory, and quality assurance provider complaints; timely and continuous reconciliation of provider records; oversees Provider Access and Availability by reviewing Appointment Availability Audits conducted by staff.
- Provides support and maintenance assistance for websites, portals, directories, manuals, and dashboards; plans, coordinates, and conducts provider forums and monthly webinars; develops communications including newsletters.
- Provides assistance and support to other departments, as needed, to obtain crucial or required information from Providers, such as HEDIS, Credentialing. Grievance and Appeals, SIU, etc. Coordinates provider status information with member services and other internal department.
- Promotes and educate providers on cultural competency.
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- Experience with Microsoft (PowerPoint, Word).
- Strong time management and organizational skills.
- Experience with Managed Care, Provider Network.
- Bachelor's Degree or equivalent combination of education and experience.
The typical pay range for this role is:
$46,988.00 - $91,800.00
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 Benefits | CVS Health
We anticipate the application window for this opening will close on: 11/08/2024
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.