Cigna Healthcare
Healthcare
ProviderContractingSeniorManager
Neural analysis suggests this role is
optimal for Manager candidates.
“Provider Contracting Senior Manager at Cigna Healthcare. Skills: Provider contracting, Network management, Negotiation. Manage contracts and negotiations. Build relationships with providers”
What You'll Achieve.
Achieve competitive position; Maintain competitive position
Industry & Context.
Problem solving; Decision making
What They're Looking For.
Must Have
Bachelor degree or industry experience, 5 years contracting experience, Knowledge of complex reimbursement methodologies
Nice to Have
MBA or MHA preferred, Prior experience in network governance, Prior experience managing direct reports, Prior experience leading project teams, Experience developing provider relationships
What You'll Do.
Manage contracts and negotiations
Build relationships with providers
Seek value-based business opportunities
Manage network composition
Manage competitive position
Manage network strategy
Initiate communication channels
Maintain communication channels
Meet unit cost targets
Preserve adequate network
Lead value-based relationships
Resolve provider service complaints
Negotiate with partners
Resolve escalated issues
Manage key provider relationships
Interface with providers
Understand provider landscape
Ensure contract loading
Ensure timely submissions
Interface for network implementation
Interface for network maintenance
How You'll Work.
Team & Collaboration
Matrix partners; Provider partnerships; Internal/external partners; Business staff
Communication Scope
Written communication; Verbal communication; Formal presentations
Full Job Description
This person must be based out of the TN market. The Assistant Vice President, Network Management / Provider Contracting Senior Manager serves as an integral member of Cigna's local market network management and provider contracting team, and reports to the Vice President of Network Management. This role is a key contributor to affordability, medical cost management, and strategy for the West Tennessee market. **_DUTIES AND RESPONSIBILITIES_** * Manages contracts and negotiations for fee for service and value-based collaborative programs with hospitals, physicians, and other providers. * Potential to directly manage other contracting associates, providing leadership and mentoring. * Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy. * Responsible for Cigna's cost of care, affordability, network composition, and competitive position for commercial networks. * Responsibility for network and business strategy for other customer segments such as Medicare and individual, should they apply to the market. * Initiates, nurtures 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. * Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position. * Lead collaborative, value-based relationships with local providers. * Assists in resolving elevated and complex provider service complaints. Researches problems and negotiates with internal/external partners/customers to resolve highly complex and/or escalated issues. * Manages key provider relationships and is accountable for critical interface with providers and business staff. * Demonstrates comprehensive knowledge of providers in an assigned geographic area through understanding the interrelatio
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