Location Virtual, US Category Operations Posted Date: 06/17/2020
Job Id 20009726
This position serves as an integral member of the Provider
Contracting Team and reports to the Provider Contracting
DirectorMarket Lead. This role is a key contributor to the
development of the strategic direction and is accountable for the
management of contracting and network management activities for
multiple local geographies.
DUTIES AND RESPONSIBILITIES
Directly manages a contracting team or 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 (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,
Claims Operations, Medical Management. Credentialing, Legal,
Medical Economics, Compliance, Sales and Marketing and Service.
Manages strategic positioning for provider contracting, develops
networks and identifies and acts upon opportunities for greater
value-orientation and risk arrangements.
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 network, to achieve and maintain Cigna's competitive
Identify and manages initiatives that improve total medical cost
Drives change with external provider partners by assessing
clinical informatics and offering consultative expertise to assist
with total medical cost initiatives.
Prepares, analyzes, reviews, and projects financial impact of
high spend or increasingly complex provider contracts and alternate
Creates and / or oversees the development of “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 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.
Bachelor’s degree strongly preferred; 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.
Minimum of 5 years contracting and negotiating experience
involving complex delivery systems and organizations required.
Prior experience managing direct reports and leading project
teams in a non-centralized work environment preferred.
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
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 and change leadership in a
Superior problem solving, decision-making, negotiating skills,
contract language and financial acumen.
Knowledge and use of Microsoft Office tools.
Cigna Corporation (NYSE: CI) is a global health service company
dedicated to improving the health, well-being and peace of mind of
those we serve. We offer an integrated suite of health services
through Cigna, Express Scripts, and our affiliates including
medical, dental, behavioral health, pharmacy, vision, supplemental
benefits, and other related products. Together, with our 74,000
employees worldwide, we aspire to transform health services, making
them more affordable and accessible to millions. Through our
unmatched expertise, bold action, fresh ideas and an unwavering
commitment to patient-centered care, we are a force of health
When you work with Cigna, you’ll enjoy meaningful career
experiences that enrich people’s lives while working together to
make the world a healthier place. What difference will you make? To
see our culture in action, search #TeamCigna on Instagram.
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 an accommodation based on your physical or mental
disability please email: SeeYourself@cigna.com. Do not email
SeeYourself@cigna.com for an update on your application or to
provide your resume as you will not receive a response.
About Cigna Employment with Cigna, including employment within
the LDP program, is at-will; that is, it is not for a specified
period of time and can be terminated at any time for any reason,
with or without cause or notice, by me or by Cigna. LDP programs,
policies and processes may be changed by Cigna at any time.