Provider Relations Lead Analyst - Cigna Healthcare - Remote

Cigna Healthcare

$66K — $111K *
US-AnywhereRemote in United States
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree or equivalent work experience required.
  • 5+ years in provider relations industry preferred.
  • Account management experience supporting providers is required.
  • Knowledge of medical insurance products preferred.
  • Experience with MS Office Suite, Tableau, Facets, ETQL or Proclaim preferred.
  • Ability to lead an account management team towards common goals is essential.
  • Outstanding oral, written, and negotiation skills are necessary.

Responsibilities

  • Manage the overall provider experience for a mid/low complexity book of business.
  • Collaborate with local markets to enhance provider experience.
  • Develop and maintain strategic action plans for individual providers.
  • Identify and address new opportunities and risks for providers.
  • Capture and disseminate market intelligence to drive improvements.
  • Engage with providers virtually as their main point of contact.
  • Monitor performance guarantees and promote improvements in Provider Index scores.

Benefits

  • Medical, vision, and dental insurance offered from day one.
  • Well-being and behavioral health programs available.
  • 401(k) plan with company contributions.
  • Company-paid life insurance and tuition reimbursement.
  • Minimum of 18 days of paid time off plus paid holidays.
  • Includes leaves of absence.
Full Job Description
SUMMARY

This position is an external provider facing role with account management responsibilities for a medium to low complex book of business. The role is accountable for the overall provider experience by working in collaboration with matrix partners to drive on-going service improvements, understand, articulate and resolve service impacts, 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 and is responsible for continuously building improving 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
  • Leads, collaborates, and supports local market direction as it relates to improving the provider experience
  • Creates and maintains individual provider strategic action plans
  • Proactively identify new opportunities and risks for providers 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 strategic improvements
  • External/virtual facing with providers 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 providers
  • Proactively educate providers 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
  • Serves as a provider advocate both internally and externally
  • Serves in a consultative role or subject matter expert to key matrix partners
  • Develops and participates in presentations to existing and prospective providers 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


QUALIFICATIONS
  • Bachelor's degree or higher strongly preferred or equivalent work experience required.
  • 5+ years of experience working in the provider relations industry is highly preferred.
  • Account management experience supporting a provider book of business is required.
  • Knowledge of medical insurance products and associated provider issues is strongly preferred.
  • Experience with MS Office Suite, Tableau, Facets, ETQL or Proclaim is highly preferred.
  • Ability to lead an account management team and other matrix partners to a common goal.
  • Demonstrated excellent oral, written, interpersonal, analytical, and negotiation skills.
  • Ability to work in a matrix environment.
  • Up to 25% travel may be required.


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.

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