Provider Contracting Manager – Cigna Healthcare – Walnut Creek, CA
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Job Location:
Walnut Creek, CA - USA
Monthly Salary:
Not Disclosed
Posted on:
11 hours ago
Vacancies:
1 Vacancy
Job Summary
Join Cigna Healthcare a division of The Cigna Group and help shape our provider network. As aProvider Contracting Manageryoullreport to the Provider Contracting Senior Manager AVP Network this individual contributor roleyoullassistin developing the strategic direction and management of day-to-day contracting and network management.
Responsibilities
Manage complex fee-for-service and value-based contracting and negotiations with large physician groups ancillaries and hospital systems.
Lead key market contracting strategy projects with responsibility for managing direct reports as assigned.
Build andmaintainstrong provider relationships to support network growth and value-based business opportunities.
Coordinate closely with matrix partners (i.e. Claims Medical Management Credentialing) to ensure aligned execution.
Develop strategic network positionsidentifyvalue-oriented and risk-based opportunities and contribute to alternative network initiatives and analytics.
Work to meet unit cost targets whilemaintainingan adequate competitive provider network.
Design and manage initiatives to improve medicalcostand quality offering consultative guidance informed by clinical informatics.
Prepare review and project thefinancial impactof large or complex provider contracts and alternative terms.
Create implement and ensure operational accuracy of HCP agreements through effective cross-functional collaboration.
Lead resolution of escalated provider issues and manage key provider relationships with deep knowledge of the local market landscape including contract loading and maintenance.
Required Qualifications
The ideal candidate will work a hybrid schedule in the Walnut Creek CA office.
3years of healthcare provider contracting and negotiating experience involving complex physician groups and ancillaries
Background in managed care healthcare or health insurance including commercial contracting
Proven leadership experience including mentoring and guiding others
Strong provider relationship management skills and success developing long-term-partnerships
Knowledge of complex reimbursement methodologies including incentive-based models (strongly preferred)
Deep understanding of hospital managed care and provider business models with the ability to influence sales and provider audiences
Exceptional presentation and communication skills including the ability to build internal relationships in a fast-paced matrixed organization
Customer-centric approach strong interpersonal skills and confidence in navigating change
Strong problem-solving decision-making negotiation contract interpretation and financial analysis skills
Proficiencyin Microsoft Office
Preferred Qualifications
Bachelors degree in a related field (industry experience may substitute); MBA / MHA preferred
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 of 106400 - 177300 USD / 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.
At The Cigna Group 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 health-related benefits including medical vision dental and well-being and behavioral health programs. We also offer 401(k) 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 click here.
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
- Revenue Cycle Management
- HIPAA
- Healthcare Management
- PMBOK
- Microsoft Outlook
- Project Leadership
- Data Management
- Project Management
- Affiliate Marketing
- Project Management Software
- Supervising Experience
- Workday
About Company
Cigna Healthcare offers health insurance plans such as medical and dental to individuals and employers, international health insurance, and Medicare coverage.
