Senior Manager, Provider Relations Manager – Metro NY

CVS Health

Senior Manager overseeing provider relations and network management at CVS Health. Driving network growth and ensuring high-quality provider relationships across assigned markets.

Posted 6/19/2026full-timeNew York City • New York • 🇺🇸 United StatesSenior💰 $82,940 - $199,144 per yearWebsite

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

network managementprovider relationsperformance metricsdispute resolutionprovider engagementvalue-based caredata analysisaction planningcompliancemanaged care

Soft Skills

strategic leadershipcollaborationproblem solvingcommunicationstaff managementrelationship managementcross-functional teamworkcustomer serviceadaptabilityconflict resolution

Tools & Technologies

Aetna’s internal systemsclaims management systemsinteroperability toolscontracting systemsperformance monitoring toolsprovider satisfaction surveysdata analytics softwaretelephonic communication toolsvirtual meeting platformsCRM systems

Industry Keywords

healthcare operationsprovider communityMetro NY marketCommercial lines of businessMedicare lines of businessprovider facing experienceregulatory compliancecontractual requirementsservice issuesescalations

About the role

Key responsibilities & impact

Provides strategic leadership and oversight for network management and provider relations
Develops and implements network strategies, monitors provider performance metrics, leads dispute resolution processes, and collaborates with key stakeholders to drive network growth and ensure high-quality provider relationships
Manages local provider relations staff to ensure Market Leading Provider Satisfaction scores
Provides service to providers by resolving problems and advising providers of new protocols, policies and procedures
Leads and manages strategic relationships with hospitals, physician groups, and ancillary providers across an assigned market or portfolio
Conducts shadowing during provider visits on-site, virtual, and telephonic
Drives provider performance related to quality, cost efficiency, access, and member experience metrics
Partners closely with Network Management, Medical Management, Value-Based Care, Operations, and Finance to execute provider strategies
Identifies opportunities to improve provider engagement, resolve escalated issues, and strengthen collaboration across the provider network
Supports value-based care initiatives, including education, performance monitoring, and provider adoption of new models
Analyzes provider’s performance data and develops action plans to address gaps or risks
Serves as a senior point of contact for complex provider concerns or operational challenges
Works cross functionally with additional teams including claims, appeals, interoperability, and contracting to develop creative solutions and root cause issues
Ensures compliance with regulatory, contractual, and company requirements

Requirements

What you’ll need

7-10 years of experience in healthcare operations, provider relations, managed care, or network management within a payer or provider organization
A minimum of 2 years leadership/management experience leading staff to ensure department goals are met
Demonstrated experience managing provider relationships, including resolving complex service issues, escalations, and provider concerns
Must have provider facing experience
Ability to travel within the Metro NY market to the NYC office or providers offices as needed
Knowledge of the local market provider community
Knowledge of Aetna’s internal systems
Working knowledge of Commercial and Medicare lines of business

Benefits

Comp & perks

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs