drjobs Provider Contract & Network Underwriting Advisor (LifeSOURCE Transplant Analytics) - Hybrid

Provider Contract & Network Underwriting Advisor (LifeSOURCE Transplant Analytics) - Hybrid

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1 Vacancy
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Job Location drjobs

Bloomfield, PA - USA

Monthly Salary drjobs

Not Disclosed

drjobs

Salary Not Disclosed

Vacancy

1 Vacancy

Job Description

Summary

Cigna is seeking a highly motivated and innovative team member to join our growing and dynamic LifeSource Transplant Analytics team as a Provider Contract & Network Underwriting Advisor. In this role you will assist contractors in creating network solutions and provider contracts to ensure Cignas competitive position in the market. You will use financial models to evaluate the impact of proposed terms on profitability trend and other metrics. You will also partner with network management medical management and sales units to understand resulting medical expense results and improve future negotiation strategy.

Responsibilities

  • Effectively influence contracting in a strategic fashion and offer meaningful options during negotiations with a provider

  • Independently and effectively manage the planning process and drive the plan to meet overall corporate planning objectives

  • Proactively identify opportunities for trend reduction and engage contracting to build these into plan where appropriate

  • Provide ad hoc analysis and deep dives into data as appropriate to support negotiation and provide value to our contracting partners

  • Summarize and explain findings and recommendations

Qualifications

  • 5 years of experience in health care/managed care analytics experience; TMC and/or Contract Underwriting experience preferred

  • Strong analytical and problem solving skills with expertise in Microsoft Excel; exposure to SQL and/or SAS is a plus

  • Experience working with claim data and familiarity with standard medical coding: CPT ICD9 HCPC

  • Understanding of managed care business processes data systems and applications for claims payment enrollment benefit design and utilization management

  • Strong communication skills to include written oral and group presentation


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 ofUSD / 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. Thats why youll enjoy a comprehensive range of benefits with a focus on supporting your whole health. Starting on day one of your employment youll be offered several healthrelated benefits including medical vision dental and wellbeing 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 The Cigna Group

Doing something meaningful starts with a simple decision a commitment to changing lives. At The Cigna Group were dedicated to improving the health and vitality of those we serve. Through our divisions Cigna Healthcare and Evernorth Health Services we are committed to enhancing the lives of our clients customers and patients. 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:

Unclear Seniority

Employment Type

Full-Time

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