Cigna
Provider Contracting Lead Analyst - Richmond/McLean, VA market - Hybrid
Cigna, Richmond, Virginia, United States, 23214
WORK LOCATION:
supports our
Virginia market
- Preferred candidate to live in either
Richmond or McLean, VA area
Hybrid position - will need to work in the office or visit Providers 3 days per week
The
Provider Contracting Lead Analyst
serves as an integral member of the Provider Contracting Team and reports to the Contracting Manager or Market Lead. This role assists and supports the day to day contracting and network activities.
DUTIES AND RESPONSIBILITIES
Manages submission process of contracting and negotiations for fee for service with physicians, ancillaries and hospitals
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
Other duties, as assigned
POSITION REQUIREMENTS
Bachelor's degree strongly preferred in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a Bachelor degree
1+ years of Provider Contracting and Negotiating for Healthcare Hospital/Provider/Ancillary group experience required
1+ years prior Provider Servicing/Provider Relations experience strongly 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
Proficient with Microsoft Office tools required
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.
About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.
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.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
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supports our
Virginia market
- Preferred candidate to live in either
Richmond or McLean, VA area
Hybrid position - will need to work in the office or visit Providers 3 days per week
The
Provider Contracting Lead Analyst
serves as an integral member of the Provider Contracting Team and reports to the Contracting Manager or Market Lead. This role assists and supports the day to day contracting and network activities.
DUTIES AND RESPONSIBILITIES
Manages submission process of contracting and negotiations for fee for service with physicians, ancillaries and hospitals
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
Other duties, as assigned
POSITION REQUIREMENTS
Bachelor's degree strongly preferred in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a Bachelor degree
1+ years of Provider Contracting and Negotiating for Healthcare Hospital/Provider/Ancillary group experience required
1+ years prior Provider Servicing/Provider Relations experience strongly 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
Proficient with Microsoft Office tools required
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.
About Cigna Healthcare Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.
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.
The Cigna Group has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
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