Provider Contracting Lead Analyst - New England market
Provider Contracting Lead Analyst - New England market
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
LOCATION: Hybrid position aligned to the New England Market. Will consider candidates that live in MA RI and ME.
Preferred office location: Newton MA
The Provider Contracting Lead Analyst 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 submission process of contracting and negotiations for fee for service with physicians ancillaries and hospitals.
Supports the development and management of valuebased 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 valueorientation.
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 Cignas 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.
Other duties as assigned
POSITION REQUIREMENTS
Bachelors degree strongly preferred in the areas of Finance Economics Healthcare or Business related. Significant industry experience will be considered in lieu of a Bachelor degree.
1 years of Provider Contracting and Negotiating for Healthcare Hospital/Provider/Ancillary group experience required
1 years prior Provider Servicing experience strongly preferred
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 fastpaced matrix organization.
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 decisionmaking negotiating skills contract language and financial acumen.
Proficient with Microsoft Office tools 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.
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: for support. Do not email for an update on your application or to provide your resume as you will not receive a response.
The Cigna Group has a tobaccofree 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.
Required Experience:
IC
Employment Type
Full-Time
