Provider Relations Liaison- Detroit market

Position Summary The Provider Relations Liaison serves as the primary point of contact for assigned, high-profile providers and provider groups (including individual providers and small group practices). This role is responsible for establishing, strengthening, and maintaining productive, long‑term relationships by proactively addressing complex issues related to policies and procedures, plan design, contract language, claims, compensation, and provider education. The role collaborates closely with internal business partners to resolve escalated concerns, ensure operational excellence, and deliver a consistent, high-quality provider experience. Key Responsibilities Act as the primary relationship manager for assigned providers, serving as a trusted advisor and advocate. Manage and resolve complex provider issues, including claims payment discrepancies, contract interpretation and compliance, provider compensation questions, and demographic and contract data accuracy. Partner cross‑functionally with Operations, Claims, Contracting, Credentialing, and other internal teams to drive timely issue resolution and continuous improvement. Monitor service performance and trends, identifying opportunities to enhance provider satisfaction and operational efficiency. Support operational activities such as contract coordination, provider database maintenance, reporting, and documentation. Perform credentialing‑related support activities as needed. Educate providers on contract terms and requirements, plan design and benefits, compensation processes, technology platforms, policies, and procedures. Conduct periodic meetings (virtual or in‑person) with key providers to review service performance and address concerns. Develop meeting agendas, validate presentation materials, and facilitate external provider meetings. Collaborate with internal stakeholders on provider onboarding, contract implementations, and demographic updates. Required Qualifications 3+ years of external‑facing customer service or relationship management experience, preferably in healthcare, insurance, or benefits‑related environments. 3+ years of experience working with business‑segment‑specific policies, benefits, plan design, and contract language. Working knowledge of provider‑related codes, products, and industry terminology. Demonstrated ability to manage complex issues, prioritize competing requests, and meet service expectations. Strong verbal and written communication skills; ability to convey complex information clearly and professionally. Proven problem‑solving, critical thinking, and relationship‑building skills. Proficiency with standard business technology and data systems (e.g., CRM platforms, databases, or claims systems). Preferred Qualifications 3+ years of experience supporting or servicing healthcare providers, including exposure to benefits administration and contract interpretation. Experience working with provider networks, claims operations, credentialing, or provider contracting. Familiarity with healthcare compliance requirements and regulatory guidelines. Ability to analyze service trends and recommend process improvements. Experience facilitating provider meetings or leading cross‑functional initiatives. Education Bachelor’s degree in Business, Healthcare Administration, or a related field; or equivalent combination of education and relevant work experience. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is $46,988.00 - $102,000.00, representing 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 factors such as experience, education, geography and other relevant factors. This position is also eligible for a CVS Health bonus, commission or short‑term incentive program in addition to the base pay range. Benefits This full‑time position is eligible for a comprehensive benefits package that includes medical, dental, and vision coverage; paid time off; retirement savings options; wellness programs; and other resources, based on eligibility. Additional details about available benefits are provided during the application process and through Benefits Moments. EEO Statement Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. #J-18808-Ljbffr