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Provider Contracting Sr Manager

Company: Cigna
Location: Nashville
Posted on: June 12, 2021

Job Description:

This position serves as an integral member of Cigna's local market network management and Medicare Advantage provider contracting team, and reports to the Vice President of Network Management. This role is a key contributor to affordability, medical cost management, and strategy for the Middle Tennessee and Kentucky market. This position but must be based in the greater Nashville area preferred.

DUTIES AND RESPONSIBILITIES

  • Manages contracts and negotiations for fee for service and value-based collaborative programs with hospitals, physicians, and other providers.
  • Potential to directly manage other contracting associates, providing leadership and mentoring.
  • Builds relationships that nurture provider partnerships and seeks broader value-based business opportunities to support the local market strategy.
  • Responsible for Cigna's cost of care, affordability, network composition, and competitive position for commercial networks.
  • Responsibility for network and business strategy for other customer segments such as Medicare and individual, should they apply to the market.
  • 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.
  • Responsible for meeting unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.
  • Lead collaborative, value-based relationships with local providers.
  • 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.

POSITION REQUIREMENTS

  • Should possess a bachelor degree. 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 models.
  • 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 dynamic environment.
  • Superior problem solving, decision-making, negotiating skills, contract language and financial acumen.
  • Knowledge and use of Microsoft Office tools.

About Cigna

Cigna Corporation exists to improve lives. We are a global health service company dedicated to improving the health, well-being and peace of mind of those we serve. Together, with colleagues around the world, 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 us, or one of our subsidiaries, you'll enjoy meaningful career experiences that enrich people's lives. What difference will you make?

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.

Keywords: Cigna, Nashville , Provider Contracting Sr Manager, Other , Nashville, Tennessee

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