National Provider Contract Advisor
1 month ago
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.
Work Location: Remote or Hybrid
[If live close to a Cigna Office the position would be Hybrid and require 3 days in the office]
National Contracting plays a significant role in Cigna's Enterprise Affordability strategy. Direct Provider Agreements managed by National Contracting are a key growth opportunity for Cigna and play a critical role in delivering affordability and network access for our Customers and Clients These agreements currently represent roughly $2B in annual medical spend across US Commercial and US Government and growing. Heavy focus on controlling unit costs and trends in these contracts is critical for Cigna to achieve Affordability goals.
The National Provider Contracting Advisor is a key role in supporting Cigna's overall affordability programs, which directly address customer and client demands for lower cost and higher quality of care. This role will report to the Provider Contracting Sr Director focusing on national direct provider agreements and will be supporting that team's contracting strategy.
Key Responsibilities:
- Lead and/or advise on complex national provider agreements, negotiations, legal review and signature processes
- Manage and/or support the agreement and amendment request and preparation processes, as assigned
- Responsible for accurate and timely contract loading including effective interfacing with matrix partners for network implementation and maintenance
- Coordinate appropriate business and legal review/response of negotiated documents
- Mange key national contracted providers and be accountable for critical interface with providers and their business staff
- Builds and maintains internal/external partner relationships to ensure optimal outcomes
- Contribute to National contracting strategy and partner with other team members and matrix partners to implement assigned strategies
- Incorporate Industry/Competitive trends in programs/contracts
- Partner with local markets to drive network adequacy and membership growth/persistency strategies
- Initiate and maintain 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
- Initiate and maintain effective channels of communication with providers and be accountable for critical interface with providers and business staff
- Assist with communication of contract processes and procedures
Qualifications:
- Bachelor's Degree or higher required
- 4+ years of experience in Provider, Client and Customer Relations, Provider Contracting or National Ancillary Service within a Healthcare environment
- Detailed knowledge of Cigna Affordability initiatives and medical spend categories
- Working knowledge of Cigna operations, markets and contracts
- Knowledge of US Government operations and Medicare is preferred
This role is also anticipated to be eligible to participate in an annual bonus plan.
We want you to be healthy, balanced, and feel secure. That's why you'll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you'll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna.
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.
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