Provider Relations Manager - Cigna Healthcare - Remote - KS, MO

About this role

Candidates who reside within 50 miles of the following locations may be asked to work in person three days per week: Overland Park, KS or St. Louis, MO.

In order to support the business and due to the assigned Book of Business, we are planning to hire a candidate from Kansas or Missouri.

SUMMARY  

The Provider Relations Manager / Provider Relations Lead Analyst, is a n external provider facing role with account management responsibilitie s for a medium to low complex bo ok of b usiness. The role is accounta ble for the overall provider e xperience by working in collaboration with matrix partners to drive on-going service improvements, understand, articulate and resolve service imp acts, and drive the overall provider strategic planning solutions. This individual is empowered within their scope to make decisions as it pertains to the experience with Cigna , is required to have local market knowledge and visibility, builds and continuously improv e the relationship between Cigna and the provider .  

DUTIES AND RESPONSIBILITIES  

• Accountable for the end-to-end provider experience and overall service delivery for assigned Book of Business aligned to medium to low complex providers  

• L eads, collaborates, and supports local market dir ection as it relates to improving the provider experience  

• Creates and maintains individual provider strategic action plans  

• Proactively identify new opportunities and risks for provider s at market or national level and drives resolution  

• Exercises good judgment and discretion to support the provider experience  

• Responsible for capturing, documenting, and sharing market intelligence; use market intelligence to develop and drive s trategic im provements  

• External facing with provider s in assigned BOB   

• Collect, analyze, interpret, translate and distribute provider informatics, reports, dashboards  

• Track and monitor performance guarantees for assigned BOB  

• Promotes Provider Index score improvement through proactive and effective service and support of network  

• Review provider reports/dashboard with individual provider s  

• Pr oactively educate provider s on Cigna 's business objectives , standard operating procedures, policies and programs to influence behavior and how to work with Cigna  

• Serve as a provider advocate both internally and externally  

• Understands and applies service culture principles and methodology  

• Serve s as a provider advocate both internally and externally  

• Serve s in a consultative role or subject matter expert to key matrix partners  

• Develops and participates in presentations to existing and prospective provider s and/or clients  

• Serves as advocate in external community, representing CIGNA to medical societies and external provider associations.  

• Manage joint operating committees, including agenda development, facilitating appropriate meeting participation and follow up activities  

PREFERRED QUALIFICATIONS  

• Bachelor's degree or higher strongly preferred or equivalent work experience required.

• 5 + years of experience in provider relations highly preferred.

• Claims administration experience is highly preferred.

• Solid root cause analysis with claims issues is highly preferred.

• Experience with MS Office (Word, Outlook, PowerPoint) is highly preferred.

• Solid experience with Excel (to include pivot tables and VLOOKUP) is highly preferred .  

• Knowledge of other systems include Proclaim, Facets and PWB would be preferred.

• Understanding of medical insurance products and associated provider issues is highly preferred.

• Ability to lead cross-functional partners to a common goal.

• Demonstrated excellent oral, written, interpersonal, analytical, and negotiation skills.  

• Ability to work in a matrix environment.  

• Travel may be required (up to 25%)

CORE COMPETENCIES  

• Organizational savvy, Plans and aligns,   Collaborates, Communicates Effectively, Interpersonal Savvy, Tech Savvy,   Being Resilient, Action oriented, Decision quality, Customer Focus, Builds Networks, Instills Trust  

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 66,600 - 111,000 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, you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll 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, paid holidays, and leaves of absence. For more details on our employee benefits programs, click here .

About The Cigna Group

Doing something meaningful starts with a simple decision, a commitment to changing lives. At The Cigna Group, we’re 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

Similar jobs

• Account Manager – Remote - Cigna Global Health Benefits — The Cigna Group · United States Work at Home | Phoenix, AZ
• Provider Contracting Manager - Cigna Healthcare - Seattle, WA — The Cigna Group · Seattle, WA
• Health Claims Examiner - Cigna Healthcare - Remote — The Cigna Group · Remote
• 26003594 Sales Development/Inside Sales Consultant, East - Remote - Cigna Global Health Benefits — The Cigna Group · Remote
• Provider Relations Coordinator — Morganmorganjobsapplynow · Lexington, Kentucky, United States
• Middle Market Client Experience Consultant; Denver, CO - Hybrid - Cigna Healthcare — The Cigna Group · Denver, CO
• Account Executive - Cigna Pharmacy - Remote — The Cigna Group · Remote
• Dedicated Client Service Partner, Cigna Healthcare - Hybrid, FL — The Cigna Group · Clinic - Hernando County - 15470 Flight Path Dr - Brooksville, FL