The job profile for this position is Provider Contracting Advisor, which is a Band 4 Senior Contributor Career Track Role. Excited to grow your career? We value our talented employees, and whenever possible strive to hel…
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Other, Full-time
Posted 25d ago
~40 hrs/week
Responsibilities
Manage complex fee-for-service and value-based contracting and negotiations with large physician groups and hospital systems. Develop strategic network positions and collaborate with matrix partners to improve medical cost and quality.
Requirements
Requires 3+ years of healthcare provider contracting experience with a background in managed care or health insurance. Must possess strong leadership, financial analysis, and provider relationship management skills.
Full job description
The job profile for this position is Provider Contracting Advisor, which is a Band 4 Senior Contributor Career Track Role.
Excited to grow your career?
We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!
Our people make all the difference in our success.
Join Cigna Healthcare, a division of The Cigna Group, and help shape our provider network. As a Network Contracting Manager, 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.
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, identify 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+ 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
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
Proficiency in Microsoft Office
If you will be working at home occasionally or permanently, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload.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.
The Cigna Group is a global health company committed to creating a better future built on the vitality of every individual and every community. We relentlessly challenge ourselves to partner and innovate solutions for better health.
The Cigna Group includes products and services marketed under Cigna Healthcare, Evernorth Health Services or its subsidiaries. The Cigna Group maintains sales capabilities in more than 30 countries and jurisdictions, and has more than 190 million customer relationships around the world.
Offices: 900 Cottage Grove Rd, Bloomfield, Connecticut 06002, US
How much do Finance & Accounting jobs in Georgia pay?
Based on 1586 listings with disclosed salaries, most finance & accounting jobs in Georgia pay between $65k–$189k per year. Individual offers vary with seniority, company size, and specialization.
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