Provider Relations Manager - Cigna Healthcare - Remote - CA

The job profile for this position is Provider Relations Lead Analyst, which is a Band 3 Senior Contributor Career Track Role.

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Due to the Book of Business, we are looking to hire from the California area.

SUMMARY

The Provider Relations Manager (Provider Relations Lead Analyst) position is an external provider facing role with account management responsibilities for a medium to low complex book of business. The role is accountable for the overall provider experience by working in collaboration with matrix partners to drive on-going service improvements, understand, articulate and resolve service impacts, and drive the overall provider strategic planning solutions.

This individual is empowered within their scope to make decisions as it pertains to the experience with Cigna, is required to have local market knowledge and visibility, builds and continuously improve the relationship between Cigna and the provider.

 

DUTIES AND RESPONSIBILITIES

•Accountable for the end-to-end provider experience and overall service delivery for assigned Book of Business aligned to medium to low complex providers

•Leads, collaborates, and supports local market direction as it relates to improving the provider experience

•Creates and maintains individual provider strategic action plans

•Proactively identifies new opportunities and risks for providers at market or national level and drives resolution

•Exercises good judgment and discretion to support the provider experience

•Responsible for capturing, documenting, and sharing market intelligence; use market intelligence to develop and drive strategic improvements

•External facing with providers in assigned BOB

•Collect, analyze, interpret, translate and distribute provider informatics, reports, dashboards

•Track and monitor performance guarantees for assigned BOB

• Promotes Provider Index score improvement through proactive and effective service and support of network

•Review provider reports/dashboard with individual providers                                         

•Proactively educates providers on Cigna's business objectives, standard operating procedures, policies and programs to influence behavior and how to work with Cigna

•Understands and applies service culture principles and methodology

• Serves as a provider advocate both internally and externally

•Serves in a consultative role or subject matter expert to key matrix partners

•Develops and participates in presentations to existing and prospective providers and/or clients

•Serves as advocate in external community, representing Cigna to medical societies and external provider associations.

•Manage joint operating committees, including agenda development, facilitating appropriate meeting participation and follow up activities

 

QUALIFICATIONS                                                                     

Bachelor's degree or higher strongly preferred or equivalent work experience.

5+ years of experience in provider relations preferred.

Successful account management experience preferred.

Claims administration experience preferred.

Solid experience using Outlook, Teams, Excel, PowerPoint, Word, etc.

Experience with Proclaim or Facets preferred.

Demonstrated excellent oral, written, interpersonal, analytical, and negotiation skills.

Understanding of medical insurance products and associated provider issues.

Ability to assist an account management team through issue resolution.

Ability to work in a matrix environment.

Up to 10% travel required.  

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.

For this position, we anticipate offering an annual salary of 66,600 - 111,000 USD / yearly, depending on relevant factors, including experience and geographic location.

This role is also anticipated to be eligible to participate in an annual bonus plan.

At The Cigna Group, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k), company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here.

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.

Qualified applicants with criminal histories will be considered for employment in a manner consistent with all federal, state and local ordinances.