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Provider Engagement Senior Advisor - Cleveland, Ohio

Company: Cigna
Location: Hartford
Posted on: April 8, 2021

Job Description:

Provider Engagement Senior Advisor - Cleveland, Ohio Location Virtual, US Category Operations Posted Date: 03/31/2021 Job Id 21005284 As a global health service company, our mission is to improve the health, well-being, and peace of mind of those we serve by making health care simple, affordable, and predictable. Our global workforce of more than 74,000 employees are dedicated to living our mission and being champions of our customers and communities each and every day. That's why when you work with us, you can count on a different kind of career - you'll make a difference, learn a ton, and share in changing the way people think about health care. We're making real progress, but we still have work to do. That's where you come in. Position Summary: --You'll be responsible for establishing and managing an innovative global risk and outcomes-based network. You must possess the energy and creative drive to effectively assemble, mobilize and lead a capable team responsible for complex contracting with primary care providers, specialists, hospitals, and ancillaries that will help shape the future growth and development of the market. Network Operations Senior Advisor Assist with the development and maintenance of a provider network within your designated territory. Develop relationships that nurture provider partnerships and seek broader shared savings and global risk / value-based opportunities to support the local market strategy in achieving quality, growth and financial performance targets. Manage initiatives that improve total medical cost and quality. Responsible for oversight of accurate and timely contract loading, configuration, and interface with matrix partners for network implementation and maintenance. Assist with market's HEDIS, CAHPS, and HOS strategy in collaboration with matrix partners in Stars, Coding Accuracy, and Care Management teams. Ensure accurate implementation and administration through matrix partners. Assist in resolving elevated and complex provider service complaints. Research problems and negotiate with internal/external partners to resolve highly complex and/or escalated issues. Lead joint operating committee meetings with providers with a focus on key financial, regulatory, and contract performance metrics. Degree in health administration, business administration, or another related field (Master's Degree desirable) and/or equivalent relevant experience focused on managed Medicare and provider engagement. Working knowledge of provider issues and competitor strategies, complex contracting options, financial/contracting arrangements and regulatory requirements. Experience managing and negotiating value-based contracts. In-depth knowledge of various reimbursement structures and payment methodologies for both hospitals and providers. Knowledge of regulatory requirements with emphasis on Medicare strongly preferred. Ability to assume broader organizational responsibilities as warranted.-- Excellent presentation skills. Preferred Requirements Management experience from a managed care organization, health plan, or provider system with direct knowledge of Medicare global risk, value-based, and fee-for-service contracting. Delegation This role is a remote position that requires 50% of local travel to the Cleveland, OH area. Must reside in Ohio to be considered. This position is not eligible to be performed in Colorado. About Cigna 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 services innovation. 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 reasonable accommodation in completing the online application process, please email: SeeYourself@cigna.com for support. 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.

Keywords: Cigna, Hartford , Provider Engagement Senior Advisor - Cleveland, Ohio, Other , Hartford, Connecticut

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