ProviderContractingAdvisor

**WORK LOCATION: will need to live in Tennessee** The **Provider Contracting Advisor (Director, Network Management)** serves as an integral member of the Provider Contracting Team and reports to the **Provider Contracting Sr. Manager** (**AVP, Network Management).** This role assists in developing the strategic direction and management of the day to day contracting and network management activities for a local given territory. _DUTIES AND RESPONSIBILITIES_ * Manages complex contracting and negotiations for fee for service and value-based reimbursements with hospitals and other providers (e.g., Hospital systems, Ancillaries, and large physician groups). * Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities 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. * Contributes to the development of alternative network initiatives. Supports and provides direction to develop network 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. * Creates and manages initiatives that improve total medical cost and quality. * Drives change with external provider partners by assessing clinical informatics and offering consultative expertise to assist with total medical cost initiatives. * Prepares, analyzes, reviews, and projects financial impact of larger or complex provider contracts and alternate contract terms. * Creates healthcare provider agreements that meet internal operational standards and external provider expectations. Ensures the accurate implementation, and administration through matrix partners. * Assists in resolving elevated and complex provider service complaints. Researches pr