Manager, Provider Network Management
2 weeks ago
LOCATION:
REMOTE/HYBRID position aligned to the Utah markets. Must reside in Salt Lake City, UT
The Manager, Provider Network Management serves as an integral member of the Provider Contracting Team.
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).
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.
Manages strategic positioning for provider contracting, develops networks and identifies opportunities for greater value-orientation and risk arrangements.
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.
Creates "HCP" 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 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 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.
May provide guidance or expertise to less experienced specialists.
POSITION REQUIREMENTS
Bachelor Degree required, preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a Bachelor degree. MBA or MHA preferred.
3+ years Provider Contracting and Negotiating experience involving complex delivery systems and organizations required.
Commercial and Medicare Contracting experience required
Good understanding of CMS regulations
Experience in developing and managing key provider relationships
Knowledge of complex reimbursement methodologies, including incentive based models strongly preferred.
Demonstrated experience in seeking out, building and nurturing strong external relationships with provider partners.
Intimate understanding and experience with hospital, managed care, and provider business models.
Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization.
The ability to influence both sales and provider audiences through strong written and verbal communication skills. Experience with formal presentations.
Customer centric and interpersonal skills are required.
Demonstrates managerial courage as well as an ability to maneuver effectively in a changing environment.
Superior problem solving, decision-making, negotiating skills, contract language and financial acumen.
Proficient with Microsoft Office (Word, Excel, PowerPoint, Outlook)
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.
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.
Do not email 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.
-
Catheter Manufacturing Manager
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States Spectrum Plastics Master Full timeJob DetailsLevelManagementJob LocationApollo - Sandy - Sandy, UTPosition TypeFull TimeEducation Level4 Year DegreeJob ShiftDayJob CategoryManufacturingDescriptionCompany Details: Spectrum Plastics Group (SPG) is a global supplier of engineered medical components and value-added solutions for the medical device and contract manufacturing industries. With a...
-
Account Manager
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States Blue Skies Admin Services Full timeCLICK HERE TO APPLY ON OUR SITE We are seeking an experienced, highly motivated, and organized individual to join our team as an Account Manager. In this role, you will be responsible for managing incoming leads, answering all incoming calls and emails, and providing exceptional service for our high-end Window Cleaning business. Additionally, as an Account...
-
Sr. Treasury Management Specialist
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States Capital Community Bank Full timeAs a member of CC Bank's Account Relationship Management (ARM) team, you will make a difference by delivering integrated technology solutions to help clients more efficiently manage their businesses and working capital needs. This team supports the bank's ongoing business development and cash management services that are continuously being developed and...
-
Product Customer Success Manager
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States NICE Systems, Inc. Full timeNICE Systems, Inc. Product Customer Success Manager SANDY , Utah Apply Now The Customer Success Manager will be accountable for building long-term relationships with new and existing customers by being prescriptive, proposing enhancements to product and/or services and leveraging appropriate company resources to address how clients can better interact with...
-
Supply Chain Manager
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States Cariloha LLC Full timeJob Type Full-timeDescriptionAbout Cariloha:Cariloha is an omni-channel brand focused on soft and sustainable bedding, bath, and apparel made from better-for-the-planet bamboo viscose. Driven by a comfort and eco-conscious lifestyle, Cariloha joins the style of the Caribbean with the spirit of Aloha to provide the best in sustainable luxury. By turning...
-
Assistant Project Manager
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States Lennar Corp., Full timeOverviewWelcome Home Build your career with Lennar:As one of the nation's largest builders, Lennar has built over one million new homes for families across America. Since 1954, our communities have catered to all lifestyles and family dynamics, whether you are a first-time or move-up buyer, multigenerational family, or active adult.At Lennar, Everything's...
-
Smart Buildings Branch General Manager
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States Siemens Full timeHere at Siemens, we take pride in enabling sustainable progress through technology. We do this through empowering customers by combining the real and digital worlds. Improving how we live, work, and move today and for the next generation We know that the only way a business thrive is if our people are thriving. That's why we always put our people first. Our...
-
Le Pontet, Provence-Alpes-Côte d'Azur, United States American Express Full time**Description** **You Lead the Way. Weve Got Your Back.** With the right backing, people and businesses have the power to progress in incredible ways. When you join Team Amex, you become part of a global and diverse community of colleagues with an unwavering commitment to back our customers, communities and each other. Here, youll learn and grow as we help...
-
Senior Information Security Engineer
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States NICE Systems, Inc. Full timeJob Title: Senior Information Security Engineer Overview:We are seeking a highly skilled and experienced Senior Information Security Engineer to join our team. The ideal candidate will be responsible for designing, implementing, and maintaining security measures to protect our organization's computer systems, networks, and SaaS products. This role requires a...
-
Human Resources Generalist
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States Turning Point Centers Full timeOverview: PURPOSE STATEMENT: Responsible for providing support to the Human Resources Director/Manager with a primary focus on processing and updating employee information, personnel files, record keeping, correspondence and new hire paperwork as well as assisting in the coordination and implementation of numerous HR initiatives and programs....
-
Benefit Analyst, Employee Benefits
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States HUB International Full timeJOB TITLE Benefit Analyst REPORTS TO Client Services Director EMPLOYMENT STATUS Full Time FLSA STATUS Non-Exempt LOCATION Sandy, Ut SALARY RANGE $25.00-$33.00 Job purpose The purpose of the Benefit Analyst is to support the Account Executives, Advisors and Sr. Benefit Analyst with quoting, reporting and other strategic analytic processes. This position works...
-
Material Handler II
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States STERIS Full timeAt STERIS, we help our Customers create a healthier and safer world by providing innovative healthcare and life science product and service solutions around the globe. About Us: At STERIS Applied Sterilization Technologies (AST), We are One Team with One Goal. Through a network of nearly 60 facilities globally, STERIS AST has been committed to patient safety...
-
Client Service Associate
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States HUB International Full timeHUB is the 5th largest global insurance and employee benefits broker, providing a broad array of property, casualty, risk management, life and health, employee benefits, investment and wealth management products and services. With over 18,000 employe Client Service, Associate, Service, Microsoft, Project Management, Client Support, Retail
-
Social Worker
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States Intermountain Health Full timeJob Description:The Emergency Department Social Work Care Manager works collaboratively with physicians and other members of the health care team to improve the health of patients with chronic conditions or complex needs. The position educates patients and caregivers to help them manage their health care needs. The incumbent facilitates communication,...
-
Financial Planning
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States Suncrest Home Health & Hospice Full timeWhy Suncrest: At Suncrest Hospice our goal is to change the expectation of hospice care in your area by providing exceptional care and service to our patients. This is achieved by allocating the resources to increase our staff to patient ratios, thereby increasing clinical visits while lowering clinician caseloads. We are proud to be a Community Health...
-
Marketing Specialist
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States Penn Foster Inc Full timeWe're looking for an exceptional full-time Marketing Specialist - Account Manager to join our team at Saddle Rock Legal Group , and we couldn't be more excited Are you a driven and detail-oriented individual who loves to work with data? Do you have a passion for marketing analysis and want to be part of a forward-thinking team? Then we want you As a member...
-
Production Supervisor
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States Spectrum Plastics Master Full timeJob DetailsPosition: Manufacturing Production SupervisorCompany: Apollo Inc.Level Experienced Job Location Sandy, UT Job Shift Day DescriptionDuties and ResponsibilitiesEnsure compliance with safety policies and procedures on the production floor Enhance manufacturing processes for ISO, OSHA, and customer requirements Engage on the production floor to...
-
Extrusion Operator
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States Spectrum Plastics Master Full timeJob DetailsLevelEntryJob LocationApollo SandySandy, UTPosition TypeFull TimeJob ShiftDayJob CategoryManufacturingThis position is responsible for operating essential, complex extrusion machinery to produce quality product to documented specifications. The primary function is to maintain the equipment, raw materials, color, packaging and other related...
-
Vice President of Operations
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States Coronis Health Full timeVice President of Operations FSLA Status: Full-Time, Exempt Reports to: Division PresidentJOB DESCRIPTION:The VP will report directly to the Division President. The candidate will be responsible for oversight and management of the division's overall operational functions, client success and performance outcomes. The VP will manage the departments budget...
-
Facilities Coordinator
2 weeks ago
Le Pontet, Provence-Alpes-Côte d'Azur, United States Comcast Full timeComcast brings together the best in media and technology. We drive innovation to create the world's best entertainment and online experiences. As a Fortune 50 leader, we set the pace in a variety of innovative and fascinating businesses and create career opportunities across a wide range of locations and disciplines. We are at the forefront of change and...
