As a Provider Contracting Manager, you'll report to the Provider Contracting Senior Manager, AVP Network Management. In this individual contributor role, you'll assist in 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 and maintain strong 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 positions, identify value-oriented and risk-based opportunities, and contribute to alternative network initiatives and analytics.
- Work to meet unit cost targets while maintaining an adequate, competitive provider network.
- Design and manage initiatives to improve medical cost and quality, offering consultative guidance informed by clinical informatics.
- Prepare, review, and project the financial impact of 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 - 3+ years 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
- Proficiency in Microsoft Office
Preferred Qualifications - Bachelor's 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 106,400 - 177,300 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 and paid holidays. For more details on our employee benefits programs, click here.
