Regional Medicare Provider Contracting Senior Manager

1 month ago

Remote, Oregon, United States The Cigna Group Full time

The Regional Medicare Provider Contracting Senior Manager serves as an integral member of the Network Development and Solutions Team for the Pacific Northwest and Mountain States Region and reports to the Medicare Provider Contracting Regional Vice President. This role is a key contributor to the development of the strategic direction of assigned markets and is accountable for the management of value-based and fee-for-service contracting and network management activities for multiple local geographies.

DUTIES AND RESPONSIBILITIES

  • Directly manages a contracting team and geography, providing leadership and mentoring to their direct reports.
  • Manages increasingly complex contracts and negotiations for fee-for-service and sophisticated value-based reimbursements with hospitals and other providers for Cigna's Medicare product lines (e.g., Hospital systems, ancillaries, and large physician groups) for one or more geographies.
  • Proactively builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
  • Initiates, nurtures, and maintains effective channels of communication with matrix partners including but not limited to, local market provider engagement, claims operations, clinical, Legal, analytics, compliance, sales, and provider relations.
  • Manages strategic positioning for provider contracting, develops networks, and identifies and acts upon opportunities for greater value-orientation.
  • Identifying and implementing alternative network initiatives. Supports and provides direction to develop network analytics required for the network solution.
  • Responsible for meeting unit cost targets, while preserving an adequate and marketable network, to achieve and maintain Cigna's competitive position.
  • Identify and manages initiatives that improve total medical cost and quality.
  • Prepares, analyzes, reviews, and projects financial impact of high spend or increasingly complex provider contracts and alternate contract terms.
  • Creates and/or oversees the development of Provider agreements (ie: Hospital systems, ancillaries, and physician groups) 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. Research 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 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

POSITION REQUIREMENTS

  • Location: Candidate must be located in Washington, Oregon, Colorado, Utah, or Nevada.
  • Should possess a bachelor's degree; preferably in the areas of Finance, Economics, Healthcare or Business related or equivalent work experience.
  • 5+ years Contracting and negotiating experience involving complex delivery systems and organizations required. Medicare Advantage experience required.
  • Experience with Physician, Hospital and Ancillary group contracting and negotiations.
  • Prior experience managing direct reports.
  • Experience in developing and managing key provider relationships including senior executives.
  • Knowledge of complex reimbursement methodologies, including incentive based models required.
  • Demonstrated experience in seeking out, building, and nurturing strong external relationships with provider partners.
  • Intimate understanding and experience with larger, more complex integrated delivery systems, 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 provider audiences through strong written and verbal communication skills. Experience with formal presentations.
  • Customer centric and interpersonal skills are required.
  • Demonstrates managerial courage and change leadership in a dynamic environment.
  • Superior problem solving, decision-making, negotiating skills, contract language and financial acumen.
  • Proficient with Microsoft Office (Word, Excel, PowerPoint, Outlook).
  • Proficient in contract building software such as Contract Manager.

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.For this position, we anticipate offering an annual salary of 127, ,100 USD / yearly, depending on relevant factors, including experience and geographic location.

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 Group.

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: for support. 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.

  • Provider Relations Senior Advisor – National Ancillary Medicare Advantage Vendor Service and Operations

    4 weeks ago

    Remote, Oregon, United States The Cigna Group Full time

    This is a Medicare Advantage position. Work Location: This is a Remote positionThe National Ancillary Senior Advisor is a key role that supports Cigna's Medicare Advantage line of business, directly addressing customer and client demands for higher quality of care and greater affordability for the senior population. The primary focus for this role includes...

  • National Provider Contract Advisor

    1 month ago

    Remote, Oregon, United States The Cigna Group Full time

    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...

  • Business Project Senior Analyst

    1 month ago

    Remote, Oregon, United States The Cigna Group Full time

    The job profile for this position is Network Operations Senior Analyst, which is a Band 3 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...

  • Senior Contracts Manager

    2 months ago

    Remote, Oregon, United States Flexe Full time

    Flexe solves the hardest omnichannel logistics problems for the world's largest retailers and brands. Integrating technology, open logistics networks, and elastic economic models allows Flexe customers to move fast, at scale, and with precision. Founded in 2013 and headquartered in Seattle, Flexe brings deep logistics expertise and enterprise-grade...

  • Senior Region Manager, Research Empowered Communities-West Region

    1 month ago

    Remote, Oregon, United States Care Access Full time

    What We DoCare Access is delivering the future of medicine today Care Access has a revolutionary model that breaks down traditional barriers to clinical trials that limit participation among physicians and patients to 3%. By removing this bottleneck, Care Access is helping accelerate the approval and delivery of critical and life-saving therapies.Who We...

  • Medicare Fulfillment Business Production Support Program Senior Advisor

    4 weeks ago

    Remote, Oregon, United States The Cigna Group Full time

    The job profile for this position is Program Management Senior 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...

  • Regional Sales Manager

    3 weeks ago

    Remote, Oregon, United States Claire's Full time

    Regional Sales Manager Opportunity - Central US/PlainsAbout the RoleThe Regional Sales Manager is responsible for overseeing regional activities to maximize sales, ensure delivery of a positive customer experience, and minimize costs. Provide motivation, direction, and coaching to District Sales Managers to achieve superb execution of Company programs and...

  • Regional Operations Manager

    6 days ago

    Remote, Oregon, United States FAAC Parking Solutions Full time

    Job OverviewWe are looking for a Regional Operations Manager to play a key role in our organization. This position will oversee operations across the Southeast and Seaboard States, with a designated home office.Key Responsibilities:Lead, mentor, and develop all Field Service Technicians (FST) and associated personnel.Foster a robust culture focused on...

  • Cigna Medicare Clinical Operations Case Management Analyst

    1 month ago

    Remote, Oregon, United States The Cigna Group Full time

    The job profile for this position is Case Management Analyst, which is a Band 2 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...

  • Regional Recruiting Manager

    2 months ago

    Remote, Oregon, United States Unum Full time

    Job Posting End Date: August 09When you join the team at Unum, you become part of an organization committed to helping you thrive.Here, we work to provide the employee benefits and service solutions that enable employees at our client companies to thrive throughout life's moments. And this starts with ensuring that every one of our team members enjoys...

  • Regional Manager

    4 weeks ago

    Remote, Oregon, United States Signify Health Full time

    How will this role have an impact?Each Regional Manager will have the opportunity to change health care across this country. Their work has purpose; the capacity to strengthen the financial stability of struggling health care organizations, improve the quality of life of thousands of patients, and bring joy back into the workplace. They will work closely...

  • Regional Operations Manager

    2 days ago

    Remote, Oregon, United States FAAC Parking Solutions Full time

    Job OverviewWe are looking for a Regional Operations Manager to take on a vital role within our organization, overseeing operations across the North Central States.Key Responsibilities:Lead, mentor, and enhance the skills of all Field Service Technicians (FST) or associated personnel.Foster a robust culture of accountability and customer focus among team...

  • Regional Sales Manager

    3 weeks ago

    Remote, Oregon, United States EDB Full time

    A Little About UsEDB provides a data and AI platform that enables organizations to harness the full power of Postgres for transactional, analytical, and AI workloads across any cloud, anywhere. EDB empowers enterprises to control risk, manage costs and scale efficiently for a data and AI led world. Serving more than 1,500 customers globally and as the...

  • Regional Sales Manager

    1 month ago

    Remote, Oregon, United States Imprivata Full time

    DescriptionCome join a winning team Here at Imprivata, you'll see a dedicated group of professionals who care about improving healthcare. Our team thrives on collaboration and sharing ideas, whether in a cross-functional meeting or at one of our virtual team-building events. While we're diverse in our backgrounds and skills, we have much in common. A passion...

  • Medicare Robotics Process Automation

    4 weeks ago

    Remote, Oregon, United States The Cigna Group Full time

    The job profile for this position is Product Management Senior Supervisor, which is a Band 3 Management 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...

  • Regional Sales Manager

    3 weeks ago

    Remote, Oregon, United States ChampionX Full time

    ChampionX is seeking a Regional Sales Manager to drive the sales growth for the Windrock product line within the West Region.What's in it For You: You will join a growing company offering competitive pay and comprehensive benefits package that includes medical, dental, vision, 401(k) with company matching and more Access to best-in-class resources, tools,...

  • Provider Data Senior Associate

    1 month ago

    Remote, Oregon, United States The Cigna Group Full time

    The job profile for this position is Provider Data Senior Representative, which is a Band 2 Professional 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...

  • Regional Sales Manager

    1 month ago

    Remote, Oregon, United States Highway 9 Networks Full time

    DescriptionAbout Highway9 NetworksA venture-backed Silicon Valley startup working in the Private 5G spaceEnables "mobile first" businesses, and extends the 5G rollout. A SaaS based Enterprise Mobile offering leveraging a private cellular underlayProvides a cloud driven, enterprise operated solution for in-building and campus wireless: voice & dataExtends...

  • Product Management Senior Director

    1 month ago

    Remote, Oregon, United States The Cigna Group Full time

    ROLE SUMMARY:The Senior Director of Regulated Markets Audit and Clinical Operations provides strategic direction, guidance and management for a team that is responsible for Regulated Markets clinical operations, audit readiness and coverage determination capabilities oversight. This role is responsible for driving line of business (Medicare, Medicaid and...

  • Senior Vice President, Regional Chief Financial Officer

    1 day ago

    Remote, Oregon, United States Ascension Full time

    Job SummaryThe Senior Vice President, Regional Chief Financial Officer is a key leadership position at Ascension, responsible for overseeing the financial resources and strategic planning for their respective markets.Key ResponsibilitiesParticipate in the development and execution of the organization's vision, policies, and short/long-term objectives for...