Senior Manager, Provider Relations (Pennsylvania)

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.

As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.

Position Summary

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 and ensure high-quality provider relationships.

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  Manages local provider relations staff to ensure Market Leading Provider Satisfaction scores
  
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  Co-facilitates provider Advisory Group and JOC meetings to work with management to implement changes via coordination Quality Management to develop appropriate clinical measure improvements and implement those measures in the provider community
  
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  Escalations: Provides service to providers by resolving problems and advising providers of new protocols, policies and procedures.
  
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  Assist in creation of reports, attend, and present at Plan committee meetings (Grievance, SIC, etc.)
  
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  Coordinate's provider information with member services and other internal departments as requested.
  
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  Conduct shadowing during provider visits on-site, virtual, telephonic
  
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  Monitor after-visit provider survey
  
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  Maintain local policies and procedures
  
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  Provides service to providers by resolving problems and advising providers of new protocols, policies, and procedures.
  
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  Active participation in State and regulatory audits
  
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  Travel within Market as needed.
  
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  Conference participation, as needed
  

Required Qualifications

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  Must reside in Pennsylvania.
  
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  A minimum of 2 years leadership/management experience.
  
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  Must have provider facing experience.
  
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  Strong communication, critical thinking, problem resolution, interpersonal skills, organizational and time management skills.
  
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  Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization.
  
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  Demonstrated ability to influence and collaboration with internal and external partners via strong written and verbal communications.
  
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  Experience leading / managing staff to ensure department goals are met.
  

Preferred Qualifications

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  Demonstrated ability to identify and manage initiatives that improve total medical cost and quality.
  
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  Knowledge of the local market provider community.
  

Education

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  Bachelor's degree preferred or a combination of professional work experience and education.
  

Pay Range

The typical pay range for this role is:

$75,400.00 - $165,954.00

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. This position also includes an award target in the company's equity award program.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

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  Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
  
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  No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
  
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  Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.
  

For more information, visit https://jobs.cvshealth.com/us/en/benefits

We anticipate the application window for this opening will close on: 06/28/2025

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.