Provider Relations Experience Manager

1 month ago

Maitland, Florida, United States The Cigna Group Full time

***Please note incumbent must geographically reside in Kissimmee, FL or Orlando, FL

POSITION SUMMARY:

  • This position is a high functioning role with account management and strategic planning responsibilities for a specific Health Care Professional (HCP) Book of Business. The role is accountable for the overall Health Care Professional Experience by working in collaboration with matrix partners to drive on-going service improvements, understand, articulate and resolve service impacts, and drive the overall HCP strategic planning solutions. This individual is empowered to make decisions as it pertains to the Client's experience with CIGNA, is required to have local market knowledge and visibility, builds and continuously improve the relationship between CIGNA and the HCPs. DUTIES AND RESPONSIBILITIES
  • Accountable for the end-to-end HCP experience for assigned Book of Business (complex Client, HCP groups, hospitals, ancillaries, physicians - PCPs & SCPs, and PHOs).
  • Responsible for overall service delivery related to problem resolution, accounts receivable, education, and communication for T1 Health Care Professional BOB
  • Leads, collaborates, and provides direction to the Account Management team as it relates to improving the HCP experience
  • Creates and maintains individual HCP strategic plans
  • Provides direction regarding overall service objectives and assignments as defined in strategic plan to assigned HCP Book of Business (BOB)
  • Owns end-to-end management and execution of corrective action plans – strategic and administrative
  • Proactively identify new opportunities and risks for HCPs at market or national level and drives resolution
  • Exercises good judgment and discretion to support the HCP experience
  • Responsible for coordinating, directing, and implementing Service Intent Review (SIR) as defined by the SIR strategy
  • Participate in local professional associations/organizations
  • Responsible for capturing, documenting, and sharing market intelligence; use market intelligence to develop and drive strategic improvements
  • External facing with HCPs in assigned BOB --- serves as a single point of accountability for the HCP experience
  • Collect, analyze, interpret, translate and distribute HCP informatics with Account Management team
  • Review HCP reports/dashboard with individual HCPs
  • Proactively educate and influence HCPs on CIGNA's business objectives, standard operating procedures, policies and programs
  • Set and manage expectations both internally and externally
  • Track and monitor performance guarantees for assigned BOB
  • Understands and applies service culture principles and methodology
  • Serve in a consultative role or subject matter expert to key matrix partners
  • Develop and manage relationships with providers manage and monitor internal metrics and service performance for providers
  • Identifies provider needs and responds to inquiries with knowledgeable and timely responses
  • Ensures timely execution of compliance with CIGNA standards for HCP's in assigned BOB
  • Identifies provider education opportunities and provides proactive training on a continuous basis
  • Develops and participates in presentations to existing and prospective providers and/or clients
  • Leads and provides oversight to projects or process improvement initiatives
  • Serves as advocate in external community, representing CIGNA to medical societies and external provider associations.
  • Convenes and participates in physician and administrative focus/advisory groups
  • Manage joint operating committees, including agenda development, facilitating appropriate meeting participation and follow up activities
  • Facilitates education and discussion on products, quality initiatives, disease management programs, joint ventures, etc.POSITION REQUIREMENTS
  • College degree or equivalent work experience.
  • 10+ years of experience in provider relations, account receivable management in the health care industry
  • Previous Account Receivable and Provider Relations experience preferred
  • Demonstrated excellent oral, written, interpersonal, analytical, and negotiation skills.
  • Ability to use PC software and multiple CIGNA systems.
  • Understanding of medical insurance products and associated HCP issues
  • Ability to lead an account management team
  • Ability to work in a matrix environment.
  • 25-50% travel 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: 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.

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