> Markdown version of [/jobs/ext/970691-network-relations-consultant](https://www.wearedevelopers.com/jobs/ext/970691-network-relations-consultant). Every page supports `.md` or `Accept: text/markdown`. Links point to the HTML versions so they work for humans too. Agent guide: [/agents.md](https://www.wearedevelopers.com/agents.md). --- # Network Relations Consultant - **Company:** CVS Health - **Location:** United States (Remote available) - **Experience:** Experienced - **Salary:** $46,988.0 - $102,000.0 - **Contract:** Permanent contract - **Skills:** Microsoft Word, Microsoft Excel, Data Integrity, Health Information Management, Microsoft Office, Electronic Medical Records, Network Support - **Published:** June 19, 2026 - **Apply:** https://dejobs.org/x/x/00424948279C4FB487ED4821CFE1693E/job/ ## About the Role * Candidates are to reside within the State of Ohio * Minimum 3 years recent Healthcare Claims experience * Excellent analytical and problem-solving skills * Strong communication, and presentation skills * Strong Microsoft Office Suite experience (Word, Excel, TEAMs) * Must be able to travel, * Recent Managed Care Network experience in Provider Relations or Network Relations * Behavioral Health experience * Medicaid experience * Strong Microsoft Word, and Excel experience preferred Education Associates degree or equivalent experience (HS diploma + 2 years relevant experience). ## Description The Network Relations Consultant acts as the primary resource for assigned, high profile providers or groups (i.e. local, individual providers, small groups/systems) to establish, oversee, and maintain positive relationships by assisting with or responding to complex issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs. The Network Relations Consultant is responsible for the following: * Conduct initial provider orientations as well as ongoing educational outreach. * Conduct Provider Forums in conjunction with the team. * Educate providers regarding policies and procedures related to referrals, claims submission, credentialing documentation, web site education, Electronic Health Records, Health Information Exchange, and Electronic Data Interface. * Enhance account relationships by investigating, documenting, and resolving provider matters and effectively handling and responding to account changes and correspondence. * Act as a liaison between the provider and the health plan ensuring a coordinated effort in improving financial and quality performance. * Monitoring service capabilities and collaborating with cross-functional departments to ensure that the needs of constituents are met and that escalated issues related but not limited to, claims payment, contract interpretation or parameters, and accuracy of provider contract or demographic information are resolved. * Supporting and assisting with operational activities that may include, but are not limited to, database management, and contract coordination. * SubmitUpdatestoDemographics or Roster modifications as needed for maintaining data integrity. * Ensures compliance of health plan, corporate, state, and federal regulations during the course of business. * Report to work on a consistent, regular basis during core business hours (8:00 am to 5:00pm). * Provide responsive and professional customer service to both internal and external customers. * Escalate issues, as necessary, to management in a timely manner. * Meet or exceed established productivity standard of 10-12 provider visits a week. * Conduct site visits when required. * Additional Travel as needed. ## Related Videos - [ZEISS & Microsoft - Building the Next Generation Medical Ecosystem in the Cloud](https://www.wearedevelopers.com/videos/424-zeiss-microsoft-building-the-next-generation-medical-ecosystem-in-the-cloud) - [Developing the Rich Text Editor for DeepL.com](https://www.wearedevelopers.com/videos/1172-developing-the-rich-text-editor-for-deepl-com) - [Exploring 5 Key Applications of AI Abundance with Blockchain Assurance](https://www.wearedevelopers.com/videos/971-exploring-5-key-applications-of-ai-abundance-with-blockchain-assurance) - [In-depth .NET Azure Functions: Isolated mode, performance and durable AI agents](https://www.wearedevelopers.com/videos/100207-in-depth-net-azure-functions-isolated-mode-performance-and-durable-ai-agents) - [The Future of Recruiting: Innovations and Challenges in the European IT Sector](https://www.wearedevelopers.com/videos/1056-the-future-of-recruiting-innovations-and-challenges-in-the-european-it-sector) - [Startup Presentation: StorX - Future of Cloud Storage](https://www.wearedevelopers.com/videos/1176-startup-presentation-storx-future-of-cloud-storage) ## Related Articles - [The Best Job Search Websites of 2025](https://www.wearedevelopers.com/magazine/368-the-best-job-search-websites-of-2025) - [Best Job Boards for Remote Work for Developers](https://www.wearedevelopers.com/magazine/290-best-job-boards-for-remote-work-for-developers) - [Fully Remote Software Engineer Jobs](https://www.wearedevelopers.com/magazine/447-fully-remote-software-engineer-jobs) - [Quick guide: How to write a Software Developer CV](https://www.wearedevelopers.com/magazine/37-quick-guide-how-to-write-a-software-developer-cv) - [System change: restart as developer?](https://www.wearedevelopers.com/magazine/39-system-change-restart-as-developer) - [Data Analyst Salary in the UK](https://www.wearedevelopers.com/magazine/278-data-analyst-salary-in-the-uk)