Contract Manager, Hospital & Physician Negotiations Hybrid Pittsburgh, PA
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Job Location:
Pittsburgh, PA - USA
Monthly Salary:
Not Disclosed
Posted on:
3 hours ago
Vacancies:
1 Vacancy
Job Summary
Were searching for a motivated relationshipdriven contracting professional who is ready to help shape our provider network across Western Pennsylvania and West Virginia. The Contract Manager is an individual contributor role where you play a key role in strengthening partnerships improving affordability and supporting better care for our customers. If you enjoy problemsolving influencing outcomes and creating meaningful impact through collaboration this is an exciting opportunity to grow and lead in a dynamic environment.
This role supports the Pittsburgh Western PA and West Virginia market and will require a hybrid work schedule.
Responsibilities
Lead complex negotiations with hospitals health systems ancillaries and large physician groups to support both feeforservice and valuebased strategies.
Build strong trustbased provider relationships that expand opportunities for partnership and help advance local market goals.
Partner closely with matrix teamsClaims Operations Medical Management Credentialing Legal Medical Economics Compliance Sales Marketing and Serviceto ensure smooth operations and contract execution.
Contribute to the design of alternative network strategies and support the development of analytics needed to evaluate network performance and opportunities.
Help achieve unit cost targets while preserving a competitive highquality provider network.
Lead and support initiatives that improve total medical cost and quality outcomes by using data insights to influence provider behavior.
Use clinical and cost analytics to guide provider partners through constructive change that supports affordability and performance improvement.
Prepare and analyze financial impact models for complex contract structures and innovative reimbursement terms.
Develop provider agreements that align with internal requirements and provider expectations ensuring accurate implementation through matrix partners.
Resolve escalated provider concerns through thoughtful engagement rootcause analysis and practical solutions.
Maintain deep knowledge of market dynamics provider relationships and competitive positioning to inform strategy and decisionmaking.
Ensure timely and accurate contract loading submissions and network maintenance activities.
Provide guidance to less experienced team members to support learning collaboration and continuous improvement.
Required Qualifications
Minimum 3 years of managed care contracting and negotiation experience within complex delivery systems.
Experience developing and managing key provider relationships.
Strong understanding of reimbursement methodologies including incentivebased and valuebased models.
Experience working with hospitals managed care organizations and provider business models.
Strong written and verbal communication skills with the ability to influence provider and sales audiences; experience delivering formal presentations.
Customerfocused approach with strong interpersonal and relationshipbuilding skills.
Ability to navigate change and contribute effectively in a fastpaced matrixed environment.
Strong problemsolving decisionmaking negotiation contract interpretation and financial analysis skills.
Proficiency with Microsoft Office tools.
Preferred Qualifications
Bachelors degree in Finance Economics Healthcare Business or a related field (industry experience may substitute).
MBA or MHA.
Experience providing guidance or support to earlycareer specialists.
Background working with network analytics or supporting network design initiatives.
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 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:
Manager
Key Skills
- EMR Systems
- Post Residency Experience
- Occupational Health Experience
- Pain Management
- SOAP
- Primary Care Experience
- Medical Management
- Suturing
- Workers' Compensation Law
- Pharmacy Residency
- Botox Experience
- Epic
About Company
Cigna Healthcare offers health insurance plans such as medical and dental to individuals and employers, international health insurance, and Medicare coverage.
