Medicare Advantage Provider Performance Enablement Senior Advisor

4 weeks ago


Atlanta, Georgia, United States The Cigna Group Full time
The job profile for this position is Network Operations 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 right for you, we encourage you to apply

Our people make all the difference in our success.

This role aligns to the Georgia market, incumbent candidate will work from local office 3 days per week.

The Provider Performance Enablement Senior Advisor is an integral part of a cross-functional, collaborative organization (which includes Market Provider Performance, Sales, Clinical Operations, Stars & Risk Adjustment, Finance , Cross-Segment Contracting, Provider Relations, and Network Development & Solutions). Reporting to the Network Operations Senior Manager or Director, this individual ensures the effective performance management of the provider network for his/her assigned sub-market and/or provider groups. The role of Senior Advisor with the Provider Performance Enablement team takes ownership for performance outcomes of the most complex relationships within the market. Often this includes multi-site health systems and national primary care clinic partners.

The Provider Performance Senior Advisor's responsibilities include:

  • Developing and managing the local physician/provider network, engaging with providers and internal stakeholders to drive high performance in quality and cost efficiency, designing and implementing programs to maintain positive relationships between the health plan, physician, providers, and practice managers.
  • Responsible for oversight of provider group financials, including monthly action plans, reviews, and verification as it relates to value based incentive contracts and performance.
  • Providing feedback and recommendations regarding participation or non-participation with new or existing agreements and financial and/or operational issues with providers.
  • Leading Stars & Risk Adjustment outcomes through local Provider Performance initiatives. Developing and implementing programs to achieve enhanced quality and affordability through physician education, training and provision of reporting and using analytics resources to identify key opportunities for utilization and cost management.
  • Acting as government program knowledge leader for the local market.
  • Responsible for maintaining compliance to CMS and company policies and guidelines.
  • Leading market initiatives and performing special projects and other duties as assigned by leadership.

Role Components

All market team members contribute to the growth and profitability of the Medicare Advantage business in their market in the following aspects:

Growing the MA Business:

The Provider Performance Senior Advisor is accountable for the growth of the assigned market in terms of financial profitability, and Star rating performance.

Delivering our Services:

The Provider Performance Senior Advisor is accountable for the exceptional delivery of services in the assigned market as evidenced by physician and member satisfaction, improvements on Star Rating and NPS score.

Managing our Costs:

The Provider Performance Senior Advisor ensures the affordability of services in the assigned market by effective control of various cost levers.

Developing our People:

The Provider Performance Senior Advisor provides informal leadership across team/s in his/her assigned market. He/she supports the effective coaching across Provider Performance Enablement team.

Collaborating with our Partners:

The Provider Performance Senior Advisor seamlessly collaborates with all applicable partners to 'solve for Cigna', and may lead cross-market initiatives that improve service delivery within the business.

Qualifications and Competencies

  • Education: Bachelor's degree required; Master's degree preferred
  • Experience: Previous provider relationship field experience; preferred at least eight (8) years direct experience with government sponsored health plans
  • Ability to apply an enterprise mindset with business acumen resulting in meeting or exceeding goals in growth and profitability
  • Demonstrate strategic thinking, customer focus and proven ability to develop strong, lasting relationships with providers resulting in deeper collaboration and satisfaction
  • Capacity for leading initiatives and influencing people on market teams; ability to drive transparency and accountability, and learn the strengths and weaknesses of the team so as to inform leadership to put people in a position to succeed
  • Ability to develop strong relationships across multiple levels of the organization
  • Effective communicator
  • Location: Strongly preferred aligned to Cigna worksite within assigned territory with in-territory travel expected often.

Technology Proficient – Microsoft Outlook, Excel, PowerPoint, Excel, and Word


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.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.



  • Atlanta, Georgia, United States The Cigna Group Full time

    The job profile for this position is Network Operations Lead 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...


  • Atlanta, Georgia, United States Elevance Health Full time

    Job Overview The Senior Medicare Cost Report Auditor is a pivotal role within our organization, operating in a virtual capacity across the United States. At Elevance Health, we are committed to enhancing healthcare through our partnerships with government entities, specifically in managing Medicare contracts and collaborating with the Centers for...


  • Atlanta, Georgia, United States Elevance Health Full time

    Job Overview Senior Medicare Cost Report Auditor This role is a remote position based in the United States. Elevance Health is an esteemed member of the healthcare sector, managing government contracts for Medicare and collaborating with the Centers for Medicare and Medicaid Services to enhance federal health initiatives. The Senior Auditor for...


  • Atlanta, Georgia, United States Elevance Health Full time

    Job Overview The Senior Medicare Cost Report Auditor is a remote position based in the United States. Elevance Health, a key player in the healthcare sector, is dedicated to enhancing federal health programs through our partnership with the Centers for Medicare and Medicaid Services. In this role, the Senior Auditor will contribute to our Medicare...


  • Atlanta, Georgia, United States US Tech Solutions Full time

    Job Title: Medicare Coverage Specialist Location: Fully remote Duration: 6 months contract Job Overview: The Medicare Coverage Specialist will collaborate with healthcare providers to manage prior authorization (PA) and drug benefit exception requests on behalf of the organization, adhering to Medicare Part D CMS Regulations. This role requires the...


  • Atlanta, Georgia, United States Staffing Firm Full time

    Job OverviewOur Staffing Firm is seeking a dedicated Medicare Claims Specialist to join a reputable health and life insurance organization.Key Responsibilities:Thoroughly review and process Medicare claims with precision and efficiency, ensuring compliance with Medicare regulations and internal policies.Detect and rectify discrepancies in claims, including...


  • Atlanta, Georgia, United States First Advantage Full time

    Job DescriptionAt First Advantage, we prioritize our people, recognizing that our strength lies in our diverse and inclusive workforce. We are a leading provider of essential background screening solutions, serving renowned Fortune 100 and Global 500 companies.Role Overview:The Senior Manager of Information Security Operations is tasked with overseeing the...


  • Atlanta, Georgia, United States First Advantage Full time

    Job DescriptionAt First Advantage, our people are our greatest asset. We are committed to creating an inclusive environment that values diverse perspectives and experiences. As a leading provider of essential background screening solutions, we empower organizations to make informed hiring decisions.Role Overview:The Senior Manager of Information Security...

  • Sales Advisor

    6 days ago


    Atlanta, Georgia, United States Monarch Sales, Inc. Full time

    Job OverviewPosition: Sales AdvisorAre you prepared to elevate your career in sales? We are collaborating with Monarch Sales, Inc. where each day you will engage in creating impactful connections with customers through your tailored sales skills. Your objective is to achieve sales goals and guide the sales team utilizing our comprehensive range of products,...


  • Atlanta, Georgia, United States Workday Full time

    Your work days are brighter here. At Workday, our journey began with a simple breakfast conversation that sparked an idea to transform the enterprise software landscape. Our unique culture, rooted in prioritizing our people, has been a cornerstone of our success. We believe that a thriving, employee-focused, and collaborative environment is essential for...


  • Atlanta, Georgia, United States Safe-Guard Full time

    Job Title: Actuarial ConsultantLocation: RemoteRelocation assistance is available.FLSA: ExemptPosition Overview:The role entails managing high-stakes and intricate Actuarial projects and initiatives. Responsibilities encompass, but are not limited to:Key Responsibilities:Facilitates profitable expansion among current partners and the onboarding of new...

  • Sales Enablement Lead

    2 weeks ago


    Atlanta, Georgia, United States TireHub LLC Full time

    Position Overview: The Sales Enablement Lead is responsible for crafting, developing, and executing the tools, methodologies, and strategies that the sales team will utilize. This position plays a crucial role in supporting field sales by providing education on best practices in sales and marketing, as well as implementing tools, technologies, and data to...


  • Atlanta, Georgia, United States Chick-fil-A Full time

    About the RoleThe Senior Lead Restaurant Safety Advisor is a key position within Chick-fil-A's Enterprise Risk Management team, responsible for providing technical leadership and consultation in the field of Restaurant specific Environmental, Health and Safety.This role serves as an advisor on Restaurant workplace safety efforts and initiatives, maintaining...


  • Atlanta, Georgia, United States Boston Consulting Group Full time

    WHAT YOU'LL DOAs a Portfolio Enablement Manager for our GenAI Assistant team, you will play a pivotal role in guiding the business strategy, measuring outcomes, and tracking progress of our digital products.You will be responsible for: Tracking progress across Product Portfolio squads against key deliverables, KPIs Setting business strategy based on user...


  • Atlanta, Georgia, United States OneTrust Full time

    Position OverviewEmpowering Innovation through TrustAt OneTrust, we harness the power of data and artificial intelligence to drive secure and responsible innovation. Our platform ensures the safe management of organizational data, enabling businesses to innovate while minimizing risks. With a robust array of solutions that encompass data security, privacy,...


  • Atlanta, Georgia, United States Bessemer Trust Full time

    Job Overview:The Client Relationship Manager plays a pivotal role in nurturing and sustaining client connections through proactive communication and the seamless delivery of services to individuals, families, trusts, and foundations. This position serves as an internal liaison between Senior Client Advisors and various service departments within the...

  • Senior Care Physician

    2 weeks ago


    Atlanta, Georgia, United States CenterWell Primary Care Full time

    Become a vital part of our dedicated healthcare teamThe Senior Care Physician (PCP) assumes a pivotal role within our collaborative care environment. We are committed to providing high-quality healthcare to our patients as a value-driven service provider. Our healthcare team consists of a diverse group of professionals, including physicians, nurses,...


  • Atlanta, Georgia, United States ChenMed Full time

    Position OverviewKey ResponsibilitiesChenMed is distinctive. You should be, too.At ChenMed, we are making a significant impact on the lives of our patients and our staff every day. Are you driven by innovation and entrepreneurship? Is your dedication and ambition exceptional? Do you uplift others with your compassion and positivity? Do you seek a company...

  • Senior Care Physician

    2 weeks ago


    Atlanta, Georgia, United States ChenMed Full time

    Position OverviewRole SummaryChenMed is distinct. You should be, too.At ChenMed, we are dedicated to enhancing lives daily for both our patients and our team members. Are you creative and entrepreneurial? Is your dedication and ambition exceptional? Do you uplift others with your compassion and positivity? Are you looking for an organization that supports...


  • Atlanta, Georgia, United States ChenMed Full time

    Position OverviewRole RequirementsChenMed is distinct. You should be, too.At ChenMed, we are making a significant impact on the lives of our patients and our team members every day. Are you creative and entrepreneurial? Is your dedication and ambition exceptional? Do you motivate others with your positivity and compassion? Do you seek a company that supports...