Cigna
Provider Relations Lead Analyst - Mid FL Market - Evernorth - Remote
Cigna, Bloomfield, New Jersey, us, 07003
Please know this role can be a work at home arrangement however, the incumbent must geographically reside in the Mid FL Market
The Provider Relations Lead Analyst is responsible for overseeing the end-to end provider experience for a defined book of business within an assigned geography. Experience Consultants are external facing and support the providers in delivering education on Cigna lines of business, changes in Cigna policies, procedures, collaborative programs and more. Experience Consultants are responsible for supporting market and national initiatives and will work in collaboration with Provider Relations Advisors, Accounts Receivable Specialists, Contracting, Market Medical Executives and other matrix partners to ensure market and national goals are achieved.
DUTIES AND RESPONSIBILITIES
Accountable for the end-to-end provider experience and overall service delivery for a defined book of business and geography
Develop and manage relationships with providers ensuring a positive experience with Cigna
Manage and monitor internal metrics and service performance for providers
Proactively identify education opportunities and influence providers on Cigna business objectives
Promotes Provider Index score improvement through proactive and effective service and support of network
Facilitates and participates in presentations to existing providers in their Book of Business
Serves as advocate representing CIGNA at external provider conferences and payer meetings (MGMA and AAHAM)
Supports National and Market level goals and initiatives such as Total Medical Cost (TMC), Collaborative Accountable Care and E-Services
Collaborates with Experience Managers (EM), Accounts Receivable Specialists (ARS) and other key matrix partners to support in timely issue resolution
Works with Market Engagement Lead to resolve complex/sensitive Provider inquiries, concerns, complaints, appeal, and grievances
Participate in joint operating committees (JOC) and assist with tasks including: agenda development, facilitating appropriate meeting participation and follow up activities
Gathers and understands competitor information regarding Provider network, participation and reimbursement methods
Responsible for capturing the Provider Experience using Cigna tools such as Accountable Relationship Tracker (ART) and monitor Daily Activities using Management Operating System (MOS)
Provide feedback to managers on issues and concerns going on in their books of business
Additional tasks may be assigned based on market need
POSITION REQUIREMENTS
Bachelor's degree or higher strongly preferred or equivalent work experience required
Solid experience in provider relations or health care is required
Solid account management experience is required
Ability to monitor metrics and service performance for providers
MS Office preferred
Demonstrated communication and negotiation skills
Understanding of medical insurance products and associated provider issues
Up to 25% travel may be required within the market
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 65,500 - 109,100 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.
We want you to be healthy, balanced, and feel secure. That's why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.
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 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.
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.
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DUTIES AND RESPONSIBILITIES
Accountable for the end-to-end provider experience and overall service delivery for a defined book of business and geography
Develop and manage relationships with providers ensuring a positive experience with Cigna
Manage and monitor internal metrics and service performance for providers
Proactively identify education opportunities and influence providers on Cigna business objectives
Promotes Provider Index score improvement through proactive and effective service and support of network
Facilitates and participates in presentations to existing providers in their Book of Business
Serves as advocate representing CIGNA at external provider conferences and payer meetings (MGMA and AAHAM)
Supports National and Market level goals and initiatives such as Total Medical Cost (TMC), Collaborative Accountable Care and E-Services
Collaborates with Experience Managers (EM), Accounts Receivable Specialists (ARS) and other key matrix partners to support in timely issue resolution
Works with Market Engagement Lead to resolve complex/sensitive Provider inquiries, concerns, complaints, appeal, and grievances
Participate in joint operating committees (JOC) and assist with tasks including: agenda development, facilitating appropriate meeting participation and follow up activities
Gathers and understands competitor information regarding Provider network, participation and reimbursement methods
Responsible for capturing the Provider Experience using Cigna tools such as Accountable Relationship Tracker (ART) and monitor Daily Activities using Management Operating System (MOS)
Provide feedback to managers on issues and concerns going on in their books of business
Additional tasks may be assigned based on market need
POSITION REQUIREMENTS
Bachelor's degree or higher strongly preferred or equivalent work experience required
Solid experience in provider relations or health care is required
Solid account management experience is required
Ability to monitor metrics and service performance for providers
MS Office preferred
Demonstrated communication and negotiation skills
Understanding of medical insurance products and associated provider issues
Up to 25% travel may be required within the market
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 65,500 - 109,100 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.
We want you to be healthy, balanced, and feel secure. That's why 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) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at Cigna Group.
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 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.
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.
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