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    AE

    Aetna

    Healthcare

    Network Relations Manager (Oklahoma)

    Field-Oklahoma, United StatesOn-SiteFull-time5+ yrs experience$54.3k – $119.3k / yearPosted 1w ago
    All Aetna jobs

    Job description

    We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

    Position Summary

    Acts as the primary resource for assigned, high profile providers and/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 Medicaid policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs.

    • Optimizes interactions with assigned providers and internal business partners to establish and maintain productive, professional relationships.
    • Monitors service capabilities and collaborate cross- functionally 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.
    • Supports or assists with operational activities that may include, but are not limited to, database management, and contract coordination.
    • Performs credentialing support activities as needed.
    • Educates Medicaid providers as needed to ensure compliance with contract policies and parameters, plan design, compensation process, technology, policies, and procedures.
    • Meets with key Providers at regular intervals to ensure service levels meet expectations.
    • Manages the development of agenda, validates materials, and facilitates external provider meetings.
    • Collaborate cross-functionally with the implementation of large provider systems, to manage cost drivers and execute specific cost initiatives to support business objectives and to identify trends and enlist assistance in problem resolution.
    • May provide guidance and training to less experienced team members.
    • Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills.
    • Collaborate with Provider Enablement & Strategy on Provider-facing communications, desktops, workflows, external trainings, reporting needs, and HUB support.
    • Other duties as assigned.

    Required Qualifications

    • A minimum of 5 years' work experience in healthcare.
    • Minimum of 3 years of experience in the healthcare industry, including provider relations, managed care, health plan operations, healthcare delivery, or a related area, with exposure to benefits and/or contract interpretation.
    • Working knowledge of business segment specific codes, products, and terminology.
    • Travel within the defined territory up to 50% of the time.
    • Must reside in Oklahoma

    Preferred Qualifications

    • 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.
    • Proficient in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).

    Education

    • Bachelor's degree preferred or a combination of professional work experience and education.

    Anticipated Weekly Hours

    40

    Time Type

    Full time

    Pay Range

    The typical pay range for this role is:

    $54,300.00 - $119,340.00

    This pay range represents 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 a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

    Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

    Great benefits for great people

    We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

    This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include 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 on
    Benefits Moments.

    We anticipate the application window for this opening will close on: 11/18/2026

    Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

    Job details are sourced from the employer's original posting.

    Open job posting
    AE

    About the company

    Aetna

    Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. Excellent benefits package, including 401k, tuition, licensure and certification reimbursement. We promote healthy & wellness lifestyles and offer specialty programs here at Aetna. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives. Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.

    View all Aetna jobs
    Industry
    Healthcare
    Open roles
    319

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