Provider Contracting Advisor - Cigna Healthcare - Charlotte, NC (Hybrid)
The Cigna Group
Provider Contracting Advisor - Cigna Healthcare - Charlotte, NC (Hybrid)
Job Description
Join Cigna Healthcare, a division of The Cigna Group, and help shape our provider network. As a Provider Contracting Advisor, you’ll report to the AVP, Provider Network Management. In this individual contributor role, you’ll assist in developing the strategic direction and management of day-to-day contracting and network management. This is a hybrid role based in Charlotte, NC. Responsibilities Manage complex fee-for-service and value-based contracting and negotiations with large physician groups, ancillaries, and hospital systems. Lead key market contracting strategy projects with responsibility for managing direct reports as assigned. Build and maintain strong provider relationships to support network growth and value-based business opportunities. Coordinate closely with matrix partners (i.e., Claims, Medical Management, Credentialing) to ensure aligned execution. Develop strategic network positions, identify value-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics. Work to meet unit cost targets while maintaining an adequate, competitive provider network. Design and manage initiatives to improve medical cost and quality, offering consultative guidance informed by clinical informatics. Prepare, review, and project the financial impact of large or complex provider contracts and alternative terms. Create, implement, and ensure operational accuracy of HCP agreements through effective cross-functional collaboration. Lead resolution of escalated provider issues and manage key provider relationships with deep knowledge of the local market landscape including contract loading and maintenance. Required Qualifications 3-5+ years of healthcare provider contracting and negotiating experience involving complex physician groups and ancillaries Background in managed care, healthcare, or health insurance, including commercial contracting Proven leadership experience, including mentoring and guiding others Strong provider relationship management skills and success developing long-term - partnerships Knowledge of complex reimbursement methodologies, including incentive-based models (strongly preferred) Deep understanding of hospital, managed care, and provider business models with the ability to influence sales and provider audiences Exceptional presentation and communication skills, including the ability to build internal relationships in a fast-paced, matrixed organization Customer-centric approach, strong interpersonal skills, and confidence in navigating change Strong problem-solving, decision-making, negotiation, contract interpretation, and financial analysis skills Proficiency in Microsoft Office Preferred Qualifications Bachelor’s degree in a related field (industry experience may substitute); MBA / MHA preferred 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 need a reasonable accommodation to complete the online application process, please email seeyourself@thecignagroup.com for assistance. Please note that this email inbox is dedicated to accommodation requests only and cannot provide application updates or accept resumes.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.Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.
Locations
- NC, Charlotte
Skills Required
- managed careintermediate
- complex reimbursement methodologiesintermediate
- Microsoft Officeintermediate
Required Qualifications
- 3-5+ years of healthcare provider contracting and negotiating experience involving complex physician groups and ancillaries (experience, 5 years)
- 3-5+ years of healthcare provider contracting and negotiating experience involving complex physician groups and ancillaries (experience, 5 years)
- Background in managed care, healthcare, or health insurance, including commercial contracting (experience)
- Background in managed care, healthcare, or health insurance, including commercial contracting (experience)
- Proven leadership experience, including mentoring and guiding others (experience)
- Proven leadership experience, including mentoring and guiding others (experience)
- Strong provider relationship management skills and success developing long-term - partnerships (experience)
- Strong provider relationship management skills and success developing long-term - partnerships (experience)
- Knowledge of complex reimbursement methodologies, including incentive-based models (strongly preferred) (experience)
- Knowledge of complex reimbursement methodologies, including incentive-based models (strongly preferred) (experience)
- Deep understanding of hospital, managed care, and provider business models with the ability to influence sales and provider audiences (experience)
- Deep understanding of hospital, managed care, and provider business models with the ability to influence sales and provider audiences (experience)
- Exceptional presentation and communication skills, including the ability to build internal relationships in a fast-paced, matrixed organization (experience)
- Exceptional presentation and communication skills, including the ability to build internal relationships in a fast-paced, matrixed organization (experience)
- Customer-centric approach, strong interpersonal skills, and confidence in navigating change (experience)
- Customer-centric approach, strong interpersonal skills, and confidence in navigating change (experience)
- Strong problem-solving, decision-making, negotiation, contract interpretation, and financial analysis skills (experience)
- Strong problem-solving, decision-making, negotiation, contract interpretation, and financial analysis skills (experience)
- Proficiency in Microsoft Office (experience)
- Proficiency in Microsoft Office (experience)
Preferred Qualifications
- Bachelor’s degree in a related field (industry experience may substitute); MBA / MHA preferred (experience)
- Bachelor’s degree in a related field (industry experience may substitute); MBA / MHA preferred (experience)
Responsibilities
- Manage complex fee-for-service and value-based contracting and negotiations with large physician groups, ancillaries, and hospital systems.
- Manage complex fee-for-service and value-based contracting and negotiations with large physician groups, ancillaries, and hospital systems.
- Lead key market contracting strategy projects with responsibility for managing direct reports as assigned.
- Lead key market contracting strategy projects with responsibility for managing direct reports as assigned.
- Build and maintain strong provider relationships to support network growth and value-based business opportunities.
- Build and maintain strong provider relationships to support network growth and value-based business opportunities.
- Coordinate closely with matrix partners (i.e., Claims, Medical Management, Credentialing) to ensure aligned execution.
- Coordinate closely with matrix partners (i.e., Claims, Medical Management, Credentialing) to ensure aligned execution.
- Develop strategic network positions, identify value-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics.
- Develop strategic network positions, identify value-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics.
- Work to meet unit cost targets while maintaining an adequate, competitive provider network.
- Work to meet unit cost targets while maintaining an adequate, competitive provider network.
- Design and manage initiatives to improve medical cost and quality, offering consultative guidance informed by clinical informatics.
- Design and manage initiatives to improve medical cost and quality, offering consultative guidance informed by clinical informatics.
- Prepare, review, and project the financial impact of large or complex provider contracts and alternative terms.
- Prepare, review, and project the financial impact of large or complex provider contracts and alternative terms.
- Create, implement, and ensure operational accuracy of HCP agreements through effective cross-functional collaboration.
- Create, implement, and ensure operational accuracy of HCP agreements through effective cross-functional collaboration.
- Lead resolution of escalated provider issues and manage key provider relationships with deep knowledge of the local market landscape including contract loading and maintenance.
- Lead resolution of escalated provider issues and manage key provider relationships with deep knowledge of the local market landscape including contract loading and maintenance.
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