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CVS Health Network Relations Specialist - Fully Remote in Springfield, Illinois

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.

Brief Description

  • Automates and manually loads all new and revised participating provider data transactions. Manages and resolves third-party contracted reimbursement issues into applicable systems.

What you will do

  • Maintains and updates provider demographic and contract information in appropriate systems to support claims adjudication and provider directories.

  • Follows area protocols, standards, and policies to provide effective and timely support.

  • Coordinates with internal/external constituents to implement new networks and complex contractual arrangements.

  • Communicates directly with providers and/or outside vendors to clarify data quality issues. Manages audits of provider information to escalate issues for resolution as appropriate.

  • Manages audits of provider information to escalate issues for resolution as appropriate.

  • Takes direction to execute techniques, processes, and responsibilities.

For this role you will need Minimum Requirements

  • 2-4 years or more work experience in data entry experience

  • 1-2 years of Provider data service background

  • Proficient in Microsoft Office Applications with proficient skills in Excel

Preferred experience:

  • 1-2 years of PRMS (Salesforce)

  • EPDB (2-4 years)

  • QNXT, QuickBase experience

  • Working knowledge of problem solving and decision-making skills

Education

  • High school diploma or equivalent required.

Pay Range

The typical pay range for this role is:

$18.50 - $37.02

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

We anticipate the application window for this opening will close on: 06/05/2024

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

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