Senior Coordinator, Pay Relations and Credentialing
Pathways - Cumberland, RI

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This position is responsible, under the supervision of the Manager for:

• Researching, maintaining and updating payer contracts for assigned accounts and territory supporting Regional Directors for Payer Relations.
• Primary point of contact for internal & external communications regarding payer relationships.
• Researching, completing and maintaining compliance with facility and delegated payers through credentialing, re-credentialing and audit processes and procedures.
• Representing Payer Relations & Facility Delegated Credentialing at internal and external meetings.
• Training of new contract coordinators and suggest development recommendations as needed

The Contract Coordinator will develop and effectively manage relationships with internal and external customers. The Contract Coordinator will interact and work directly with new and existing contracted payers across the country. Additionally, the Contract Coordinator will interface and work directly with Payer Relations Regional Directors, the Revenue Cycle Operations Teams (Accounts Receivable, Payer Enrollment/Set-up, Billing, Call Center, Credentialing), Clinical Ops Teams, Compliance, Legal, Marketing and MinuteClinic Field and Operations Management to ensure integration of all processes.

1. Contract Management & system related experience
2. Provider / Payer Credentialing and payer audit / compliance experience
3. Excellent written and verbal communication skills including formal presentation and customer service skills
4. Project management and the ability to participate on multiple cross-functional project teams to achieve on-time results.
5. Ability to manage and develop self, impact and influence team members and key stakeholders
6. Ability to understand data, reporting and make sound recommendations and decisions based on facts
7. Makes sound business decisions
8. Critical thinking
9. Ability to manage and execute under pressure with competing priorities
10. Strong credibility and relationship management skills with internal and external customers
11. Strong sales and negotiation skills with high customer service orientation
12. Excellent Microsoft Office products experience

5-8 Years of applicable experience.

Four Year College Degree

High School Diploma

CVS Caremark, through our unmatched breadth of service offerings, is transforming the delivery of health care services in the U.S. We are an innovative, fast-growing company guided by values that focus on teamwork, integrity and respect for our colleagues and customers. What are we looking for in our colleagues? We seek fresh ideas, new perspectives, a diversity of experiences, and a dedication to service that will help us better meet the needs of the many people and businesses that rely on us each day. As the nation’s largest pharmacy health care provider, we offer a wide range of exciting and fulfilling career opportunities across our three business units - MinuteClinic, pharmacy benefit management (PBM) and retail pharmacy. Our energetic and service-oriented colleagues work hard every day to make a positive difference in the lives of our customers.

Qualifications:

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