Behavioral Health Network Relations Manager

CVS Health

. Act as the primary resource for assigned, high-profile Behavioral Health providers and/or groups .

Posted 10/9/2026full-timeRemote • Louisiana • United StatesMid-LevelSenior💰 $54,300 - $119,340 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in Medicaid Managed Care, provider relationship management, and operational support within the behavioral health sector. Proficient in contract interpretation, provider education, and compliance with Medicaid regulatory standards.

Highest-signal resume keywords

Medicaid Managed Care ExperienceProvider Relationship ManagementContract InterpretationBehavioral Health Sector KnowledgeMicrosoft Office Suite Proficiency

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Medicaid PoliciesContract LanguageClaims ManagementCredentialing SupportMedical TerminologyCPT CodesICD-10 CodesDatabase ManagementOperational ActivitiesProvider Education

Soft Skills

CommunicationCollaborationProblem ResolutionTrainingFacilitation

Industry Keywords

Behavioral HealthNetwork Access StandardsClaim LifecycleProvider AppealsNetwork Performance Standards

About the role

Key responsibilities & impact

Act as the primary resource for assigned, high-profile Behavioral Health providers and/or groups
Establish, oversee, and maintain positive provider relationships
Respond to complex issues related to Medicaid policies and procedures, plan design, contract language, service, claims, compensation, and provider education
Optimize interactions with assigned providers and internal business partners
Monitor service capabilities and collaborate cross-functionally to resolve escalated claims, contract, and provider information issues
Support operational activities including database management and contract coordination
Perform credentialing support activities as needed
Educate Medicaid providers on contract policies, plan design, compensation processes, technology, policies, and procedures
Meet with key providers regularly to ensure service levels meet expectations
Develop agendas, validate materials, and facilitate external provider meetings
Collaborate on implementation of large provider systems, cost drivers, cost initiatives, trend identification, and problem resolution
Provide guidance and training to less experienced team members
Collaborate with Provider Enablement & Strategy on provider-facing communications, desktops, workflows, external training, reporting needs, and HUB support
Perform other duties as assigned

Requirements

What you’ll need

Minimum of 5 years' work experience in healthcare
Minimum of 3 years' experience in a Medicaid Managed Care business segment environment servicing providers, with exposure to benefits and/or contract interpretation
Minimum of 2 years’ experience working with providers and contracts in the behavioral health sector
Working knowledge of business segment specific codes, products, and terminology
Proficiency in Microsoft Office Suite, including Excel, Word, and PowerPoint
Travel within the defined territory up to 50-80% of the time
Candidates must reside in the state of Louisiana and within one of the following parishes: St. Landry, Evangeline, Acadia, Lafayette, St. Martin, Iberia, Vermillion, Beauregard, Allen, Calcasieu, Jefferson Davis, Cameron, Avoyelles, Rapides, Vernon, Grant, Winn, LaSalle, Catahoula, Concordia
Knowledge of Medicaid Regulatory Standards for Network Access, Credentialing, Claim Lifecycle, Provider Appeals & Disputes, and Network Performance Standards
Experience in Medical Terminology, CPT, ICD-10 codes, etc.

Benefits

Comp & perks

CVS Health bonus, commission or short-term incentive program in addition to base pay
Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being