ProFee Specialist

Cigna in; Bloomfield (CT); Remote; USD 96,000 - 160,000; Full time

Job summary

A leading company is seeking a Provider Contract & Network Underwriting Advisor to join their Global Data & Analytics team. This role involves strategic contracting, market planning, and data analysis to support provider negotiations in the Northeast Market. The ideal candidate will have significant experience in healthcare, strong analytical skills, and the ability to work independently. Benefits include comprehensive health coverage and a competitive salary range.

Benefits

Health coverage

401(k) with company match

Paid life insurance

Tuition reimbursement

Paid time off

Qualifications

• 5+ years of experience in healthcare or managed care.
• Experience with physician analytics.
• Familiarity with medical coding (CPT, ICD9, HCPC) preferred.

Responsibilities

• Influence contracting strategically and negotiate with providers.
• Manage planning process for assigned markets independently.
• Provide ad hoc analysis to support negotiations.

Skills

Analytical skills

Problem-solving skills

Communication skills

Tools

Microsoft Excel

Access

SAS/SQL

Job description

Job Title: Provider Contract & Network Underwriting Advisor

Cigna is seeking a highly motivated and innovative team member to join our growing and dynamic Global Data & Analytics team as a Provider Contract & Network Underwriting Advisor for the Northeast Market's Team, focusing on Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont providers.

Responsibilities

1. Influence contracting strategically and offer meaningful options during negotiations with providers.
2. Manage the planning process for assigned markets independently to meet corporate objectives.
3. Identify opportunities for trend reduction and collaborate with contracting teams to incorporate these into plans.
4. Oversee corrections and updates to forecasting tools in collaboration with PCD and Pro fee analysts.
5. Provide ad hoc analysis and deep dives into data to support negotiations and add value to contracting partners.
6. Summarize findings and make recommendations clearly.

Qualifications

• 5+ years of experience in healthcare or managed care.
• Experience with physician analytics.
• Preferred experience in TMC and/or Contract Underwriting.
• Strong analytical and problem-solving skills.
• Excellent communication skills, including written, oral, and group presentations.
• Understanding of managed care processes, data, systems, and applications.
• Familiarity with data mining and reporting tools such as Microsoft Excel, Access, or SAS/SQL.
• Ability to work independently, manage multiple tasks, and meet deadlines.
• Experience with claim data and familiarity with medical coding (CPT, ICD9, HCPC) preferred.

Remote work considerations: A reliable internet connection via cable broadband or fiber optic service with at least 10Mbps download and 5Mbps upload speeds is required.

Salary range: $96,000 - $160,000 annually, depending on experience and location, with potential eligibility for an annual bonus plan.

Benefits include health coverage (medical, vision, dental, behavioral health), 401(k) with company match, paid life insurance, tuition reimbursement, at least 18 days of paid time off, and holidays. For more details, visit Life at Cigna Group.

About The Cigna Group

We are dedicated to improving health and vitality through our divisions Cigna Healthcare and Evernorth Health Services. Join us in driving growth and making a difference.

We are an equal opportunity employer, considering all qualified applicants without regard to race, color, age, disability, sex, pregnancy, sexual orientation, gender identity, veteran status, religion, national origin, or other protected characteristics.

If you require reasonable accommodation during the application process, please email: [e-mail]. Note: Do not send resumes or updates to this email.

The Cigna Group maintains a tobacco-free policy and may not hire tobacco/nicotine users in certain states unless they participate in a smoking cessation program prior to employment. States include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, Washington.

Applicants with criminal histories will be considered in accordance with applicable laws.