CVS Health
Provider Network Relationship Manager (Ohio)
$60K–$133K
OH - Work from hom +8 · Remote · Manager · Full-time · Posted Sep 22, 2026
- Location
- OH - Work from hom
OH - Youngstown
OH - Cleveland
OH - Canton
OH - Akron
OH - Toledo
OH - Dayton
OH - Cincinnati
OH - Columbus - Experience
- 5+ years in Medicaid managed care; minimum 2 years reviewing, analyzing, and auditing healthcare claims and claims data.
- Education
- Bachelor's degree preferred, or a combination of professional work experience and education.
About the job
Build and maintain the OhioRISE provider network by managing provider relationships, contracts, performance, compliance, and network expansion.
What you'll do
- Develop productive relationships with providers and internal partners; support business strategy and resolve escalated issues.
- Monitor provider performance, contract compliance, service levels, and quality and cost measures.
- Engage and recruit providers as needed, facilitate provider meetings, and support network configuration and integration.
What they ask for
- 5+ years of experience in Medicaid managed care, including work with individual providers and complex provider systems or groups.
- Minimum of 2 years of experience reviewing, analyzing, and auditing healthcare claims and claims data.
- Experience reviewing contracts for compliance with applicable state regulatory requirements.
- Must reside in Ohio, be able to travel within the state as needed, and be proficient with MS Office Suite applications.
Nice to have
- In-depth knowledge of the behavioral health market and experience building relationships with behavioral health providers.
- Bachelor's degree preferred, or a combination of professional work experience and education.
Pay
$60,300.00 - $132,600.00 (base salary)
Tools
MS Office Suite
Model-written summary · the original posting is authoritative