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Join Cigna Healthcare, a division of The Cigna Group, and help shape our provider network. As aProvider Network Advisor,you’llreport to the Provider Contracting Senior Manager, AVP Network Management. In this individual contributor role,you’llassistin developing the strategic direction and management of day-to-day contracting and network management.
Responsibilities
Manage complex fee-for-service and value-based contracting and negotiations with large physician groups, ancillaries, and hospital systems.
Lead key market contracting strategy projects with responsibility for managing direct reports as assigned.
Build andmaintainstrong provider relationships to support network growth and value-based business opportunities.
Coordinate closely with matrix partners (i.e., Claims, Medical Management, Credentialing) to ensure aligned execution.
Develop strategic network positions,identifyvalue-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics.
Work to meet unit cost targets whilemaintainingan adequate, competitive provider network.
Design and manage initiatives to improve medicalcostand quality, offering consultative guidance informed by clinical informatics.
Prepare, review, and project thefinancial impactof large or complex provider contracts and alternative terms.
Create, implement, and ensure operational accuracy of HCP agreements through effective cross-functional collaboration.
Lead resolution of escalated provider issues and manage key provider relationships with deep knowledge of the local market landscape including contract loading and maintenance.
Required Qualifications
Candidate must reside within the market.
3+years of healthcare provider contracting and negotiating experience involving complex physician groups and ancillaries
Background in managed care, healthcare, or health insurance, including commercial contracting
Proven leadership experience, including mentoring and guiding others
Strong provider relationship management skills and success developing long-term-partnerships
Knowledge of complex reimbursement methodologies, including incentive-based models (strongly preferred)
Deep understanding of hospital, managed care, and provider business models with the ability to influence sales and provider audiences
Exceptional presentation and communication skills, including the ability to build internal relationships in a fast-paced, matrixed organization
Customer-centric approach, strong interpersonal skills, and confidence in navigating change
Strong problem-solving, decision-making, negotiation, contract interpretation, and financial analysis skills
Proficiencyin Microsoft Office
Preferred Qualifications
Bachelor’s degree in a related field (industry experience may substitute); MBA / MHA preferred
This role is also anticipated to be eligible to participate in an annual bonus plan.
At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, click here.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.Please note that you must meet our posting guidelines to be eligible for consideration. Policy can be reviewed at this link.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.