Provider Advocate (Meritain Health)

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Overview

Meritain Health provides customized benefits, cost management, and network access for millions of members. The Provider Advocate will work within Meritain, primarily with providers and claims. This person oversees various relationships with Meritain's high-profile groups and handles any relevant escalations as needed.Position Summary

• Resolves provider and network inquiries and escalations.
• Serves as single point-of-contact for network high utilization providers.
• Coordinates provider projects for mass adjustments and payment verifications to include client reimbursements or settlements.
• Attends and participates in daily dedicated Claims Touchpoint calls, specific to addressing complex provider concerns.
• Works on escalation projects through internal and external partnership.
• Works on internal and network project requests for appropriate resolution in a timely manner.
• Ensures all tickets and projects are completed with attention to detail and accuracy.
• Owns several projects from start to finish.
• Performs other duties as assigned.

Required Qualifications

• 2+ years of healthcare industry experience, specifically in provider relations.
• Demonstrated proficiency with Microsoft Office Suite, particularly Microsoft Excel.

Preferred Qualifications

• Previous experience with Salesforce.
• Previous experience in claim adjudication.
• Strong data logic efficiency.
• Ability to effectively communicate findings to the submitter and other internal departments.
• Excellent organizational skills.
• High-level analytical skills.
• Problem solving and project improvement skills.
• High comfort level with presenting case findings in meetings with upper leadership.
• Associate's or Bachelor's degree.

Education

• High school diploma or GED.

Anticipated Weekly Hours
40Time Type
Full timePay Range

The typical pay range for this role is:$46,988.00 - $122,400.00This 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 peopleWe take pride in our comprehensive and competitive mix of pay and benefits - investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefitsWe anticipate the application window for this opening will close on: 01/05/2026Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.