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Cigna Provider Contracting Representative - CT/MA/RI/NY in Boston, Massachusetts

Work Location: Must live in CT, MA, RI or NY

PROVIDER CONTRACTING REPRESENTATIVE

This position serves as an integral member of the Provider Contracting Team and reports to the Contracting Manager or Market Lead. This role assists and supports the day to day contracting and network activities.

DUTIES AND RESPONSIBILITIES

  • Manages contracting and negotiations for fee for service with physicians, ancillaries and hospitals.

  • Supports the development and management of value-based relationships.

  • Builds and maintains relationships that nurture provider partnerships to support the local market strategy.

  • Initiates 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.

  • Supports strategic positioning for provider contracting, assists in the development of networks and helps identify opportunities for greater value-orientation.

  • Contributes to the development of alternative network initiatives. Supports analytics required for the network solution.

  • Works to meet unit cost targets, while preserving an adequate network, to achieve and maintain Cigna's competitive position.

  • Supports initiatives that improve total medical cost and quality.

  • Drives change with external provider partners by offering consultative expertise to assist with total medical cost initiatives.

  • Prepares, analyzes, reviews, and projects financial impact of provider contracts and alternate contract terms.

  • Creates “HCP” agreements that meet internal operational standards and external provider expectations. Ensures the accurate implementation, and administration through matrix partners.

  • Assists in resolving provider service complaints. Researches problems and negotiates with internal/external partners/customers to resolve escalated issues.

  • Manages provider relationships and is accountable for critical interface with providers and business staff.

  • Demonstrates 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; preferably in the areas of Finance, Economics, Healthcare or Business related. Significant industry experience will be considered in lieu of a Bachelor degree.

  • 2+ years prior experience working in Provider Relations or Provider Contracting Negotiation

  • Contracting and Negotiating experience

  • Experience in developing and managing relationships

  • Understanding and experience with hospital, managed care, and provider business models a plus

  • Team player with proven ability to develop strong working relationships within a fast-paced, matrix organization

  • Excellent Communication both Oral and Written required

  • The ability to influence audiences through strong written and verbal communication skills. Experience with formal presentations.

  • Customer centric and interpersonal skills are required

  • Demonstrates an ability to maneuver effectively in a changing environment

  • Demonstrates problem solving, decision-making, negotiating skills, contract language and financial acumen

  • Proficient with Microsoft Office tools

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

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.

Cigna 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.

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