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The Regional Provider Engagement Manager is a key member of the Provider Engagement team supporting EviCores solutions by working directly with the provider community and health plan partners across nine states: Arizona New Mexico Texas California Utah Hawaii Colorado Alaska and Nevada.
This position is responsible for training providers on EviCores prior authorization processes promoting process improvement and supporting market readiness efforts. The role includes managing provider relationships delivering educational outreach and collaborating across internal departments to optimize the provider experience and ensure seamless implementation of our solutions/programs.
The Manager will support various programs including Cardiovascular Gastroenterology Laboratory Management Medical Oncology Musculoskeletal Radiation Oncology Radiology and Sleep among others. The individual will serve as a subject matter expert and collaborate cross-functionally with teams such as Sales Implementation Program and Operations.
Duties and Responsibilities:
Create and oversee market readiness strategy
Collaborate with other departments to fulfill provider engagement duties that lead to a successful implementation
Develop and lead in training sessions to providers delivering effective verbal and written communications appropriate to the audience
Conduct provider outreach activities as needed based on direction provided by our health plan partners Client management team and other areas of the business
Proactively identify and respond to issues and trends affecting multiple providers
Lead and coordinate communication with providers providing timely status of efforts to resolve escalated complex and sensitive provider issues in collaboration with other internal departments at EviCore
Provide education to provider personnel to improve overall process efficiency that is patient-centric and educates providers on EviCore products and services
Engage appropriate provider staff regarding eviCore initiatives to ensure optimal impact of overall project efforts and outcome
Ensure knowledge of all solutions/programs across organization
Facilitate meetings with provider groups that may include clinical discussion and follow-up to each meeting with applicable research and issue resolution
Track and document all provider outreach interactions
Assist with the development and management of policies and procedures relating to provider participation including management and production of online provider materials and production of provider newsletters
Develop and manage relationships with providers monitoring and reviewing key metrics and overall activity performance
Generate and analyze reports to share with provider groups to deliver pertinent information to providers to assist with process efficiency
Work with appropriate departments to develop and manage comprehensive provider reporting packages and issue tracking for assigned territory
Interact with other internal staff members to provide support with special projects or assignments
Position Requirements:
Bachelors degree in Business Healthcare related field or equivalent work experience
5 years of experience in provider relations or a similar role
Strong oral written and interpersonal communication skills
Proven ability to lead projects and present information effectively
Strong organizational analytical and problem-solving skills
Excellent project and time management capabilities
Up to 25% travel required across assigned states; travel may be limited due to public health guidelines
This is a hybrid role and will likely require the ability to work in-person.
About Evernorth Health Services
Evernorth Health Services a division of The Cigna Group creates pharmacy care and benefit solutions to improve health and increase vitality. We relentlessly innovate to make the prediction prevention and treatment of illness and disease more accessible to millions of people. 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 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.
Required Experience:
Unclear Seniority
Full-Time