Cigna Healthcare
Healthcare
ProviderContractingAdvisor
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“Provider Contracting Advisor at Cigna Healthcare. Skills: Provider contracting, Network management, Negotiations. Manage fee-for-service contracting. Manage value-based contracting”
Industry & Context.
Problem-solving; Decision-making
What They're Looking For.
Must Have
3-5+ years healthcare provider contracting, 3-5+ years negotiating experience, Background in managed care, Background in healthcare, Background in health insurance, Commercial contracting experience, Proven leadership experience, Mentoring and guiding others, Provider relationship management skills, Success developing long-term partnerships, Deep understanding of hospital business models, Deep understanding of managed care business models, Deep understanding of provider business models, Ability to influence sales audiences, Ability to influence provider audiences, Exceptional presentation skills, Exceptional communication skills, Ability to build internal relationships, Customer-centric approach, Interpersonal skills, Confidence in navigating change, Problem-solving skills, Decision-making skills, Negotiation skills, Contract interpretation skills, Financial analysis skills, Proficiency in Microsoft Office
Nice to Have
Knowledge of complex reimbursement methodologies, Knowledge of incentive-based models, MBA preferred, MHA preferred
What You'll Do.
Manage fee-for-service contracting
Manage value-based contracting
Negotiate with large physician groups
Negotiate with ancillaries
Negotiate with hospital systems
Lead market contracting strategy projects
Manage direct reports
Build provider relationships
Maintain provider relationships
Support network growth
Support value-based business opportunities
Coordinate with matrix partners
Ensure aligned execution
Develop strategic network positions
Identify value-oriented opportunities
Identify risk-based opportunities
Contribute to alternative network initiatives
Contribute to analytics
Meet unit cost targets
Maintain adequate provider network
Maintain competitive provider network
Design initiatives to improve medical cost
Design initiatives to improve quality
Manage initiatives to improve medical cost
Manage initiatives to improve quality
Offer consultative guidance
Prepare financial impact
Review financial impact
Project financial impact
Create HCP agreements
Implement HCP agreements
Ensure operational accuracy of HCP agreements
Lead resolution of escalated provider issues
Manage key provider relationships
Manage contract loading
Manage contract maintenance
How You'll Work.
Team & Collaboration
Coordinate with matrix partners; Cross-functional collaboration
Communication Scope
Presentation skills; Communication skills
Process & Methodology
Project management
Full Job Description
Join Cigna Healthcare, a division of The Cigna Group, and help shape our provider network. As a Provider Contracting Advisor, you’ll report to the AVP, Provider Network Management. In this individual contributor role, you’ll assist in developing the strategic direction and management of day-to-day contracting and network management. This is a hybrid role based in Charlotte, NC. **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 and maintain strong 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, identif _y_ value-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics. * Work to meet unit cost targets while maintaining an adequate, competitive provider network. * Design and manage initiatives to improve medical cost and quality, offering consultative guidance informed by clinical informatics. * Prepare, review, and project the financial impact of 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** * 3-5+ 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
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