Senior Manager, Provider Contracting

Role Overview

• 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.

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 in network governance highly preferred
• 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.

Benefits

• Health insurance
• Retirement plans
• Flexible work arrangements
• Professional development opportunities