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Provider Contracting Lead Analyst - Medicare

Company: Cigna
Location: Saint Louis
Posted on: September 13, 2020

Job Description:

This job is available in 4 locations Category Operations Posted Date: 08/21/2020 Job Id 20012556

This position serves as an integral member of the Network Operations Team and reports to the N etwork Operations Manager . This role assists and supports the day to day contracting and network activities and expansion into new markets.

ESSENTIAL FUNCTIONS

Manages contracting and negotiations for fee for service with physicians.

Supports the development and management of value-based relationships.

Builds and maintains relationships that nurture provider partnerships to support the local market strategy.

Initiates and maintains effective channels of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales and Marketing and Service.

Supports strategic positioning for provider contracting, assists in the development of networks and helps identify opportunities for greater value-orientation.

Contributes to the development of alternative network initiatives. Supports analytics required for the network solution.

Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.

Supports initiatives that improve total medical cost and quality.

Drives change with external provider partners by offering consultative expertise to assist with total medical cost initiatives.

Prepares, analyzes, reviews, and projects financial impact of provider contracts and alternate contract terms.

Creates “HCP” agreements that meet internal operational standards and external provider expectations. Ensures the accurate implementation, and administration through matrix partners.

Assists in resolving provider service complaints. Researches problems and negotiates with internal/external partners/customers to resolve escalated issues.

Manages provider relationships and is accountable for critical interface with providers and business staff.

Demonstrates knowledge of providers in an assigned geographic area through understanding the interrelationships as well as the competitive landscape.

Responsible for accurate and timely contract loading and submissions and interface with matrix partners for network implementation and maintenance.

QUALIFICATIONS

Bachelor’s degree strongly preferred; preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a Bachelor degree.

One to two years prior provider servicing experience strongly preferred.

Medicare Advantage experience required.

Contracting and negotiating experience preferred.

Experience in developing and managing relationships.

Understanding and experience with hospital, managed care, and provider business models a plus.

Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization.

The ability to influence audiences through strong written and verbal communication skills. Experience with formal presentations.

Customer centric and interpersonal skills are required.

Demonstrates an ability to maneuver effectively in a changing environment.

Demonstrates problem solving, decision-making, negotiating skills, contract language and financial acumen.

Knowledge and use of Microsoft Office tools.

About Cigna

Cigna Corporation (NYSE: CI) is a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. We offer an integrated suite of health services through Cigna, Express Scripts, and our affiliates including medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and other related products. Together, with our 74,000 employees worldwide, we aspire to transform health services, making them more affordable and accessible to millions. Through our unmatched expertise, bold action, fresh ideas and an unwavering commitment to patient-centered care, we are a force of health services innovation.

When you work with Cigna, you’ll enjoy meaningful career experiences that enrich people’s lives while working together to make the world a healthier place. What difference will you make? To see our culture in action, search #TeamCigna on Instagram.

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.

If you require reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. Do not email SeeYourself@cigna.com for an update on your application or to provide your resume as you will not receive a response.

About Cigna Location St. Louis, Missouri, United States of America Category Operations Posted Date 07/30/2020

Employment with Cigna, including employment within the LDP program, is at-will; that is, it is not for a specified period of time and can be terminated at any time for any reason, with or without cause or notice, by me or by Cigna. LDP programs, policies and processes may be changed by Cigna at any time.

Keywords: Cigna, St. Louis , Provider Contracting Lead Analyst - Medicare, Other , Saint Louis, Missouri

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